Surgical end effectors

ABSTRACT

According to an aspect of the present disclosure, an end effector for use with a surgical device is provided. The end effector includes a driver, a clip assembly, a needle assembly, and biasing element. The clip assembly is disposed in mechanical cooperation with the driver. Rotation of the driver results in longitudinal translation of the clip assembly. The needle assembly is selectively engaged with the clip assembly. The biasing element is disposed in mechanical cooperation with the needle assembly and is configured to bias the needle assembly proximally.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application claims the benefit of and priority to U.S. ProvisionalPatent Application No. 62/410,878 filed Oct. 21, 2016, the entiredisclosure of which is incorporated by reference herein.

TECHNICAL FIELD

The present disclosure relates to end effectors for use with a surgicaldevice for performing endoscopic surgical procedures and methods of usethereof. More specifically, the present disclosure relates to endeffectors for advancing at least a portion of a needle into tissue.

BACKGROUND

During laparoscopic or endoscopic surgical procedures, access to asurgical site is achieved through a small incision or through a narrowcannula inserted through a small entrance wound in a patient. Severaltypes of such surgical procedures include advancing at least part of aneedle and/or suture into tissue. For example, it may be desired toinsert a suture (e.g., a barbed suture) through an implant (e.g., mesh)and into tissue to help secure the implant to tissue. It may also bedesired to replace suture that was previously inserted through theimplant.

Additionally, after a needle is advanced into tissue, it may be desiredto retract the needle in an outer tube of a surgical device or an endeffector to prevent or minimize unintended contact between the needleand a physician, for instance.

Accordingly, a need exists for endoscopic surgical devices or endeffectors for use therewith including the ability to advance and retracta needle into its outer tube.

SUMMARY

The present disclosure relates to an end effector for use with asurgical device, where the end effector includes a driver, a clipassembly, a needle assembly, and biasing element. The clip assembly isdisposed in mechanical cooperation with the driver. Rotation of thedriver results in longitudinal translation of the clip assembly. Theneedle assembly is selectively engaged with the clip assembly. Thebiasing element is disposed in mechanical cooperation with the needleassembly and is configured to bias the needle assembly proximally.

In disclosed embodiments, the clip assembly engages the needle assemblywhen the needle assembly is in a first, proximal position, and the clipassembly is free from engagement with the needle assembly when theneedle assembly is in a distal position.

In aspects of the present disclosure, engagement between the clipassembly and the needle assembly resists the bias exerted on the needleassembly by the biasing element.

It is also disclosed that the end effector includes an outer tubedisposed radially outward of the driver. In embodiments, the clipassembly includes at least one arm, and the needle assembly isselectively engaged with the at least one arm of the clip assembly. Itis further disclosed that the at least one arm of the clip assembly isbiased radially outward into contact with a portion of the outer tube.In embodiments, the outer tube includes at least one aperture definedwith a distal portion of the outer tube. A portion of the at least onearm of the clip assembly is configured to engage the at least oneaperture after a predetermined amount of distal movement of the clipassembly with respect to the outer tube. Further, engagement between theat least one arm of the clip assembly and the at least one aperturecauses the clip assembly to be free from engagement with the needleassembly, and results in proximal movement of the needle assembly withrespect to the outer tube.

In disclosed embodiments, the end effector also includes a pin extendinglaterally through the outer tube. A proximal portion of the biasingelement is mechanically engaged with the pin. Further, the pin extendsthrough a longitudinal slot of the clip assembly.

It is also disclosed that the needle assembly includes a first needleextending distally from a needle block, and second needle extendingdistally from the needle block. The first needle is parallel to thesecond needle.

It is further disclosed that the end effector includes a suture disposedin mechanical cooperation with a needle of the needle assembly.

The present disclosure also relates to an end effector for use with asurgical device, wherein the end effector includes a driver assembly, adriver, a needle assembly, and a biasing element. The driver is disposedin mechanical cooperation with the drive assembly and includes athreaded portion. The needle assembly is disposed in mechanicalcooperation with the driver. Rotation of the drive assembly in a firstdirection causes distal translation of the driver and the needleassembly with respect to the drive assembly. The biasing elementdisposed in mechanical cooperation with the needle assembly, the biasingelement configured to bias the needle assembly proximally.

It is also disclosed that the needle assembly is configured to moveproximally with respect to the driver.

In disclosed embodiments, the end effector includes an outer tubedisposed radially outward of at least a portion of the drive assembly.The threaded portion of the driver is configured to engage a threadedportion of the outer tube.

It is further disclosed that a proximal portion of the needle assemblyis configured to directly engage a distal portion of the biasingelement.

Additionally, it is disclosed that the needle assembly is configured todisengage from the driver after the driver has distally travelled apredetermined amount with respect to the drive assembly.

In aspects of the disclosure, the driver includes a pair of arms biasedradially outwardly. Additionally, the end effector includes a tabextending radially inward from at least one arm of the pair of arms. Thetab is configured to releasably engage a recess of the needle assembly.In embodiments, the end effector includes an outer tube disposedradially outward of at least a portion of the drive assembly. The outertube includes at least one notch disposed adjacent a distal end of theouter tube. At least one arm of the pair of arms is configured to movefrom a first position where the at least one arm is free from engagementwith the at least one notch, to a second position where the at least onearm is engaged with the at least one notch. Further, the pair of arms isbiased from a first position where the pair of arms is engaged with theneedle assembly to a second position where the pair of arms is free fromengagement with the needle assembly. Additionally, engagement betweenthe pair of arms and the needle assembly opposes a biasing force exertedby the biasing element.

It is further disclosed that the end effector includes a suture disposedin mechanical cooperation with a needle of the needle assembly.

Further details and aspects of exemplary embodiments of the presentdisclosure are described in more detail below with reference to theappended figures.

BRIEF DESCRIPTION OF THE DRAWINGS

Embodiments of the present disclosure are described herein withreference to the accompanying drawings, wherein:

FIGS. 1 and 2 are perspective views of a surgical device including anend effector engaged therewith according to embodiments of the presentdisclosure;

FIG. 3 is an enlarged view of the indicated area of detail of FIG. 2;

FIG. 4 is a perspective view of a distal portion of an elongated portionof the surgical device of FIGS. 1-3;

FIGS. 5-8 illustrate various types of needles and sutures in accordancewith embodiments of the present disclosure;

FIGS. 9-20 illustrate various embodiments showing a needle engaged witha suture in accordance with embodiments of the present disclosure;

FIG. 21 is a perspective view of portions of an end effector inaccordance with embodiments of the present disclosure;

FIG. 22 is an assembly view of the end effector of FIG. 21;

FIG. 23 is a cross-sectional view of a portion of the end effector ofFIGS. 21 and 22;

FIG. 24 is a perspective view of a portion of the end effector of FIGS.21-23;

FIG. 25 is a perspective view of portions of the end effector of FIGS.21-24;

FIG. 26 is an enlarged view of the area of detail indicated in FIG. 25;

FIG. 27 is an enlarged view of the area of detail indicated in FIG. 25;

FIG. 28 is a perspective view of portions of the end effector of FIGS.21-27;

FIG. 29 is a perspective view of the needle of FIG. 28;

FIG. 30 is a perspective view of portions of the end effector of FIGS.21-27 and with a needle in an advanced position;

FIG. 31 is a perspective view of portions of the end effector of FIGS.21-30;

FIG. 32 is an enlarged view of the area of detail indicated in FIG. 31;

FIG. 33 is an enlarged view of the area of detail indicated in FIG. 31;

FIG. 34 is a perspective view of an end effector in accordance withembodiments of the present disclosure;

FIGS. 35 and 36 are cut-away views of portions of the end effector ofFIG. 34;

FIG. 37 is an assembly view of the end effector of FIGS. 34-36;

FIG. 38 is a cross-sectional view of an end effector in accordance withembodiments of the present disclosure;

FIG. 39 is a perspective view of a portion of the end effector of FIG.38;

FIG. 40 is an assembly view of the end effector of FIGS. 38-39;

FIG. 41 is a cross-sectional view of the end effector of FIGS. 38-40;

FIGS. 42-45 are perspective views of portions of the end effector ofFIGS. 38-41 during various stages of operation;

FIG. 46 is a perspective view of an end effector in accordance withembodiments of the present disclosure;

FIG. 47 is a perspective view of portions of the end effector of FIG.46;

FIG. 48 is an assembly view of the end effector of FIGS. 46-47;

FIG. 49 is a side view of portions of the end effector of FIGS. 46-48;

FIG. 50 is a cut-away view of the end effector of FIGS. 46-49;

FIG. 51 is a perspective view of portions of the end effector of FIGS.46-50;

FIG. 52 is a side view of portions of the end effector of FIGS. 46-51;

FIG. 53 is a cut-away view of portions of the end effector of FIGS.46-52 illustrating a needle in an advanced position;

FIG. 54 is a perspective view of portions of the end effector of FIGS.46-53 illustrating a needle in an advanced position;

FIG. 55 is a perspective view of a distal portion of the end effector ofFIGS. 46-54;

FIG. 56 is a perspective view of portions of the end effector of FIGS.46-55 illustrating a needle in a retracted position;

FIG. 57 is a perspective view of portions of an end effector inaccordance with embodiments of the present disclosure;

FIG. 58 is a cross-sectional view of the end effector of FIG. 57;

FIG. 59 is an assembly view of the end effector of FIGS. 57-58;

FIG. 60 is a cross-sectional view of the end effector of FIGS. 57-59;

FIG. 61 is a cut-away view of the end effector of FIGS. 57-60;

FIG. 62 is a cross-sectional view of the end effector of FIGS. 57-61illustrating a needle in an advanced position;

FIG. 63 is an enlarged view of the area of detail indicated in FIG. 62;

FIG. 64 is a cross-sectional view of the end effector of FIGS. 57-63illustrating the needle in a retracted position;

FIG. 65 is a perspective view of portions of an end effector inaccordance with embodiments of the present disclosure;

FIG. 66 is an assembly view of the end effector of FIG. 65;

FIG. 67 is a side view of portions of the end effector of FIGS. 65-66;

FIG. 68 is an end view of the end effector of FIGS. 65-67;

FIG. 69 is a side view of portions of the end effector of FIGS. 65-68illustrating a needle in an advanced position;

FIG. 70 is a side view of portions of the end effector of FIGS. 65-69illustrating the needle in a retraced position;

FIG. 71 is a perspective view of an end effector in accordance withembodiments of the present disclosure;

FIG. 72 is an assembly view of the end effector of FIG. 71;

FIG. 73 is a cross-sectional view of the end effector of FIGS. 71-72;

FIG. 74 is a perspective view of portions of the end effector of FIGS.71-73;

FIG. 75 is a cross-sectional view of the end effector of FIGS. 71-74illustrating a needle in an advanced position;

FIG. 76 is a cross-sectional view of the end effector of FIGS. 71-75illustrating the needle in a retracted position;

FIG. 77 is a perspective view of portions of an end effector inaccordance with embodiments of the present disclosure;

FIG. 78 is an assembly view of the end effector of FIG. 77;

FIG. 79 is a cross-sectional view of the end effector of FIGS. 77-78;

FIGS. 80 and 81 are cross-sectional views of the end effector of FIGS.77-79 illustrating a needle in an advanced position;

FIG. 82 is a cross-sectional view of the end effector of FIGS. 77-81illustrating the needle in a retracted position;

FIG. 83 is a perspective view of an end effector in accordance withembodiments of the present disclosure;

FIG. 84 is an assembly view of the end effector of FIG. 83;

FIG. 85 is a cross-sectional view of the end effector of FIGS. 83-84;

FIG. 86 is a cross-sectional view of the end effector of FIGS. 83-85illustrating a needle in an advanced position;

FIG. 87 is an enlarged view of the area of detail indicated in FIG. 86;

FIG. 88 is a perspective view of portions of the end effector of FIGS.83-87;

FIG. 89 is a cross-sectional view of portions of the end effector ofFIGS. 83-88;

FIG. 90 is a cross-sectional view of the end effector of FIGS. 83-89illustrating a barbed suture ejected therefrom;

FIG. 91 is a cross-sectional view of an end effector in accordance withembodiments of the present disclosure;

FIG. 92 is an assembly view of the end effector of FIG. 91;

FIG. 93 is a cut-away view of the end effector of FIGS. 91-92;

FIGS. 94 and 95 are perspective views of portions of the end effector ofFIGS. 91-93;

FIG. 96 is a cross-sectional view of portions of the end effector ofFIGS. 91-95;

FIG. 97 is a cross-sectional view of the end effector of FIGS. 91-96;

FIG. 98 is an enlarged view of the area of detail indicated in FIG. 97;

FIG. 99 is a perspective view of an end effector in accordance withembodiments of the present disclosure;

FIG. 100 is an assembly view of the end effector of FIG. 99;

FIG. 101 is a cross-sectional view of the end effector of FIGS. 99-100;

FIG. 102 is a cross-sectional view of the end effector of FIGS. 99-101illustrating a needle in an advanced position; and

FIG. 103 is a cross-sectional view of the end effector of FIGS. 99-102illustrating the needle in a retracted position and a barbed sutureejected from the end effector.

DETAILED DESCRIPTION OF EMBODIMENTS

Embodiments of the presently disclosed endoscopic surgical device isdescribed in detail with reference to the drawings, in which likereference numerals designate identical or corresponding elements in eachof the several views. As used herein the term “distal” refers to thatportion of the endoscopic surgical device that is farther from the user,while the term “proximal” refers to that portion of the surgical devicethat is closer to the user.

Non-limiting examples of surgical devices which may include articulationjoints according to the present disclosure include manual, mechanicaland/or electromechanical surgical tack appliers (i.e., tackers), clipappliers, surgical forceps, and the like.

Referring initial to FIGS. 1-4, a surgical instrument for use with thevarious end effectors of the present disclosure is generally designatedas surgical device 100. Surgical device 100 includes a handle assembly110, an elongated portion 120 extending distally from handle assembly110, an end effector 130 disposed in mechanical cooperation (e.g.,releasably engaged) with a distal portion of elongated portion 120, anda drive rod 150 disposed at least partially within elongated portion 120and configured to engage (e.g., releasably engage) end effector 130. Forclarity, FIGS. 1-3 illustrate a general end effector 130; various otherend effectors are shown and described throughout this application andare configured for use with surgical device 100. Generally, end effector130 is a separable component that is able to be used with a surgicalinstrument (e.g., a surgical fixation device handle). After its use(e.g., after one or more barbed sutures are released therefrom), the endeffector 130 can be removed from the remainder of the surgicalinstrument, and a new or reloaded end effector 130 can then engage thesurgical instrument and be used.

Handle assembly 110 includes a trigger or an actuator 112 (e.g., button,switch, etc.) thereon. In general, actuation of actuator 112 results inrotation of drive rod 150, e.g., in the general direction of arrow “A”in FIG. 4. There are a variety of ways surgical device 100 can transferthe movement caused by actuation of actuator 112 to rotation of driverod 150, such as those disclosed in U.S. patent application Ser. No.15/049,511, filed on Feb. 22, 2016, the entire contents of which arehereby incorporated by reference herein.

Several of the end effectors of the present disclosure are usable toadvance at least a portion of a needle and/or at least a portion of asuture (e.g., a barbed suture) or other fixation device into tissueand/or mesh, for instance. An example of a disclosed use of the endeffectors relates to positioning and/or fixation of laparoscopic ventralmesh. In such procedures, stay-sutures are typically tied to the cornersand/or cardinal points by surgeons. The mesh and sutures are then rolledand introduced through the trocar and into the laparoscopic workingspace. The mesh is then unrolled, and positioned into place. If thesutures have needles attached, care must be taken during rolling,insertion, unrolling and positioning to help ensure the needle points donot damage the mesh (especially if the mesh includes an adhesion barrierlayer) or to injure the patient or clinician. Once the mesh is properlyunrolled and placed against the abdominal wall in the correct location,the stay-sutures are delivered across the abdominal wall (either fromthe inside toward the outside using an attached needle, or from theoutside toward the inside using a suture passer introduced from outsidethe abdominal wall to grasp and pull the suture from the laparoscopicworking space). After the stay-sutures have all been inserted, theclinician can finish fixating the mesh to the abdominal wall with aseparate fixation device, such as a surgical tack applier.

The various end effectors disclosed herein help standardize surgicalprocedures (e.g., positioning and/or fixation of laparoscopic ventralmesh) and reduce the number of steps and time required to fixate themesh with stay-sutures. The needle assemblies of the present disclosureallow a surgeon to introduce and pass a stay-suture through the implantand abdominal wall without the need to pre-attach the stay-sutures toneedles, and without the risk of accidental needle sticks. The disclosedend effectors can used as a reload for use with standard surgical devicehandles to minimize the number of surgical devices (and the expense)needed for related surgical procedures.

Needle Styles

A variety of different types of needles may be used in combination withvarious embodiments of the present disclosure. While FIGS. 5-8illustrate several types of needles, other types of needles may be usedwith the various end effectors disclosed herein. FIG. 5 illustrates asingle needle 3000 a extending from a needle block 3002, and a barbedsuture 3010 a operatively engaged (e.g., releasably engaged) therewithsuch that needle 3000 a and barbed suture 3010 a are insertable into animplant/tissue, and barbed suture 3010 a remains in engagement with theimplant/tissue when needle 3000 a is retracted. A pledget 3003 a is alsoincluded adjacent proximal portions of needle 3000 a and barbed suture3010 a, which may releasably hold barbed suture 3010 a, and which mayact as a stop to help limit the distal advancement of barbed suture 3010a into the implant/tissue. A distal portion of barbed suture 3010 a maybe bent into a hollow cavity at a distal portion of needle 3000 a tohelp releasably retain barbed suture 3010 a in engagement with needle3000 a. FIG. 6 illustrates a pair of needles 3000 b disposed in aparallel relationship extending from needle block 3002, and a suture3010 b supported between needles 3000 b. Each needle of pair of needles3000 b extends distally from needle block 3002 in a direction that isperpendicular to a distal face 3002 b of needle block 3002 (e.g.,parallel to a longitudinal axis defined by an elongated portion ofsurgical device 100 engaged with needle block 3002). Pair of needles3000 b is sufficiently sturdy to support suture 3010 b therebetween. Adistal portion of suture 3010 b may be bent into a hollow cavity at adistal portion of needle 3000 b to help releasably retain suture 3010 bin engagement with needles 3000 b. It is envisioned that an adhesive isused to temporarily retain suture 3010 b in the illustrated position. Inuse, at least a portion of needles 3000 b and suture 3010 b are insertedinto/through an implant/tissue to emplace suture 3010 b through theimplant, for example. Suture 3010 b remains emplaced through the implantup retraction of needles 3000 b. Another suture 3010 b can then bepositioned between needles of pair of needles 3000 b to allow forrepeated use of pair of needles 3000 b. FIG. 7 illustrates a pair ofneedles 3000 c disposed in a bowed relationship extending from needleblock 3002, and a suture 3010 c supported between needles 3000 c.Needles 3000 c extend radially outward from each other, such that distalends 3002 c of needles 3000 c are farther apart than proximal ends 3004c of needles 3000 c. Pair of needles 3000 c is sufficiently sturdy tosupport suture 3010 c therebetween. A distal portion of suture 3010 cmay be bent into a hollow cavity at a distal portion of needle 3000 c tohelp releasably retain suture 3010 c in engagement with needles 3000 c.It is envisioned that an adhesive is used to temporarily retain suture3010 c in the illustrated position. FIG. 8 illustrates a pair of needles3000 d extending in an arcuate manner from needle block 3002, andsupporting a suture 3010 d at least partially therebetween. Further,distal portions of suture 3010 d are engaged with distal portions ofneedles 3000 d. A distal portion of suture 3010 d may be bent into ahollow cavity at a distal portion of needle 3000 d to help releasablyretain suture 3010 d in engagement with needles 3000 d. It is envisionedthat an adhesive is used to temporarily retain suture 3010 d in theillustrated position. Pair of needles 3000 d may be used when aclinician desires to secure a relatively wide portion of an implant ortissue, as the distal tips of needles 3000 d are positioned far awayfrom each other, with respect to pair of needles 3000 b and 3000 c. Itis envisioned that needles 3000 a, 3000 b, 3000 c and 3000 d are madefrom a shape memory material, such as nitinol.

Needle Tip Attachment

Several different ways of coupling needles with suture are usable withembodiments of end effectors disclosed herein and are illustrated inFIGS. 9-20. In FIG. 9, a needle 4010 is shown including a flange 4012projecting from a recess 4014 within a shaft of needle 4010. A distalend of flange 4012 may be able to move, flex or pivot away from recess4014. A barbed suture 4000 is releasably held by flange 4012. In use,distal advancement of needle 4010 towards (e.g., into) tissue causes acorresponding distal advancement of barbed suture 4000. When needle 4010is moved proximally or retracted, flange 4012 moves over or releasesbarbed suture 4000, thus leaving barbed suture 4000 within tissue, forexample.

In FIGS. 10-11, a needle 4020 is shown including an actuation suture4022 extending through needle 4020 between a recess 4024 within a shaftof needle 4020 and a proximal opening 4026 of needle 4020. A distalportion of actuation suture 4022 releasably holds barbed suture 4000. Inuse, distal advancement of needle 4020 towards (e.g., into) tissuecauses a corresponding distal advancement of barbed suture 4000. Whenactuation suture 4022 is moved proximally or retracted in the generaldirection of arrow “NTA,” distal portion of actuation suture 4022 movesin the general direction of arrow “NTB” or releases barbed suture 4000,thus leaving barbed suture 4000 within tissue, for example. It isenvisioned that a proximal portion of actuation suture 4022 is engagedwith an appropriate anchor portion of an end effector such thatadvancement of needle 4020 moves needle 4020 away from the anchorportion of the end effector, which causes a relative retraction ofactuation suture 4022.

In FIGS. 12-13, a needle 4030 is shown including a suture 4002 engagedwith a cavity 4032 of needle 4030. Cavity 4032 of needle 4030 includes afirst, proximal portion 4032 a and a second, distal portion 4032 b. Asshown, distal portion 4032 b of cavity 4032 is deeper than proximalportion 4032 a of cavity 4032. Distal portion 4032 b of cavity 4032 isconfigured to releasably engage an enlarged or ball portion 4002 a ofsuture 4002, and proximal portion 4032 a of cavity 4032 is configured toreleasably engage a body portion 4002 b of suture 4002. In use, distaladvancement of needle 4030 towards (e.g., into) tissue causes acorresponding distal advancement of suture 4002. When needle 4030 ismoved proximally or retracted, suture 4002 is able to slide in thegeneral direction of arrow “NTA” relative to needle 4030, thus leavingsuture 4002 within tissue, for example.

In FIGS. 14-15, a needle 4040 is shown including a proximal portion 4040a and a distal portion 4040 b. Proximal portion 4040 a and distalportion 4040 b of needle 4040 are releasably engaged with each other.Accordingly, moving proximal portion 4040 a proximally with respect todistal portion 4040 b, for example, can separate the two portions ofneedle 4040. A suture 4004 is engaged with a distal part of distalportion 4040 b of needle 4040. For example, a portion of suture 4004 isdisposed within a cavity 4042 of distal portion 4040 b of needle 4040.In use, distal advancement of needle 4040 towards (e.g., into) tissuecauses a corresponding distal advancement of suture 4004. When proximalportion 4040 a of needle 4040 is moved proximally or retracted, distalportion 4040 b of needle 4040 separates from proximal portion 4040 a,which results in distal portion 4040 b of needle 4040 and portions ofsuture 4004 remaining in tissue.

In FIG. 16, a needle 4050 is shown including an angled axial cut 4052disposed therein. Angled axial cut 4052 of needle 4050 is configured tofrictionally and releasably hold a portion of suture 4004 therein. Inuse, distal advancement of needle 4050 towards (e.g., into) tissuecauses a corresponding distal advancement of suture 4004. When needle4050 is moved proximally or retracted, portions of suture 4004 releasefrom angled axial cut 4052 and remain within tissue, for example. It isenvisioned that needle 4050 may be manufactured using an angled mill.

In FIG. 17, a needle 4060 is shown including a perpendicular axial cut4062 disposed therein. Perpendicular axial cut 4062 of needle 4060 isconfigured to frictionally and releasably hold a portion of suture 4004therein. In use, distal advancement of needle 4060 towards (e.g., into)tissue causes a corresponding distal advancement of suture 4004. Whenneedle 4060 is moved proximally or retracted, portions of suture 4004release from perpendicular axial cut 4062 and remain within tissue, forexample. It is envisioned that needle 4060 may be manufactured using acut off wheel.

In FIG. 18, a needle 4070 is shown including a lateral aperture 4072disposed therethrough. Lateral aperture 4072 of needle 4070 isconfigured to allow a portion of suture 4004 to be threadedtherethrough. In use, distal advancement of needle 4070 towards (e.g.,into) tissue causes a corresponding distal advancement of suture 4004.When needle 4070 is moved proximally or retracted, portions of suture4004 are removed from lateral aperture 4072 and remain within tissue,for example. It is envisioned that a pin or wire travels through needle4070 to sever suture 4004.

In FIGS. 19 and 20, a needle 4080 is shown including a slotted tip 4082.Slotted tip 4082 of needle 4080 is configured to frictionally andreleasably hold a portion of suture 4004 (FIG. 19) or multiple sutures(FIG. 20) therein. In use, distal advancement of needle 4080 towards(e.g., into) tissue causes a corresponding distal advancement ofsuture(s) 4004. When needle 4080 is moved proximally or retracted,portions of suture(s) 4004 are removed from slotted tip 4082 and remainwithin tissue, for example.

Spring Loaded Safety Cover

Referring now to FIGS. 21-33, an embodiment of an end effector 1000including a spring-loaded safety cover assembly is shown. End effector1000 is configured for use in connection with surgical device 100.Generally, end effector 1000 is configured to prevent unintentionalcontact with a needle and/or a barbed suture within or extendingdistally from its outer tube. While FIGS. 21-33 illustrate a particulartype of barbed suture 1002 and a particular type of needle 1006, endeffector 1000 may be used with different types of sutures and/orneedles.

With particular reference to FIGS. 21 and 22, end effector 1000 includesa cover 1010, a first biasing element or spring 1020, a clevis 1030, aclutch 1040, a drive element 1050, a second biasing element or spring1060 (FIG. 22), and an outer tube 1070.

Cover 1010 of end effector 1000 includes a cylindrical body portion1012, a pair of arms 1014 extending proximally from body portion 1012, alip 1016 extending radially inward from a proximal portion of each arm1014, and a tab 1018 extending radially outward from a proximal portionof one the arms 1014.

Clevis 1030 of end effector 1000 includes a body portion 1032, a pair ofarms 1034 extending distally from body portion 1032, a flange 1036extending radially outward from body portion 1032, and a plurality ofteeth 1038 disposed on a proximal end of body portion 1032. Firstbiasing element 1020 is positioned between arms 1034 of clevis 1030 andarms 1014 of cover 1010. Body portion 1032 of clevis 1030 engages aproximal end of first biasing element 1020; lips 1016 of cover 1010engage a distal end of first biasing element 1020.

A proximal portion 1007 of needle 1006 is positioned radially inward ofbody portion 1032 of clevis 1030. Further, flat portions 1007 a (seeFIG. 28) of proximal portion 1007 of needle 1006 engage correspondingflat portions 1037 of body portion 1032 of clevis 1030, thus limiting orpreventing rotation therebetween. Needle 1006 also includes a distal tip1008 and a hook 1009. Distal tip 1008 of needle 1006 is configured topierce tissue, and hook 1009 of needle 1006 is configured to engage aportion of barbed suture 1002.

Clutch 1040 of end effector 1000 includes a body portion 1042, aplurality of teeth 1044 disposed on a distal end of body portion 1042,and a proximal surface 1046. Teeth 1044 of clutch 1040 are configured toengage teeth 1038 of clevis 1030.

Drive element 1050 of end effector 1000 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to drive rod 150 ofsurgical device 100 of the present disclosure. Drive element 1050includes a proximal end 1052, a distal end 1054, and a groove 1056.Groove 1056 of drive element 1050 is configured to engage a shippingwedge (not shown) to help lock drive element 1050 in place with respectto outer tube 1070, for example. Proximal end 1052 of drive element 1050is configured to engage the drive rod. Distal end 1054 of drive element1050 is mechanically engaged with second biasing element 1060. Proximalsurface 1046 of clutch 1040 is positioned to engage second biasingelement 1060. That is, second biasing element 1060 is positioned betweenproximal surface 1046 of clutch 1040 and distal end 1054 of driveelement 1050.

Outer tube 1070 of end effector 1000 includes a proximal notch 1072, acutout 1074, and a longitudinal groove 1076 having an angled slot 1078extending therefrom. Outer tube 1070 is configured for positioningradially outward of, and to at least partially contain, at leastportions of barbed suture 1002, needle 1006, cover 1010, first biasingelement 1020, clevis 1030, clutch 1040, drive element 1050, and secondbiasing element 1060.

As shown in FIG. 23, prior to use, a portion of proximal notch 1072 islongitudinally aligned with groove 1056 of drive element 1050 such thata shipping wedge (not shown) can extend through proximal notch 1072 andinto engagement with groove 1056. The engagement between drive element1050, second biasing element 1060, clutch 1040, and clevis 1030 is alsoshown in FIG. 23. As shown, second biasing element 1060 is disposedbetween drive element 1050 and clutch 1040, thus transferring rotationalmovement from drive element 1050 (and drive rod 150, as discussed above)to clutch 1040. Additionally, second biasing element 1060 enacts adistal force onto clutch 1040 to help maintain engagement between teeth1044 of clutch 1040 and teeth 1038 of clevis 1030. Accordingly, rotationof clutch 1040 results in a corresponding rotation of clevis 1030.

With particular reference to FIG. 24, prior to use, tab 1018 of cover1010 of end effector 1000 is disposed within angled slot 1078 oflongitudinal groove 1076 of outer tube 1070. The engagement between tab1018 and angled slot 1078 prevents cover 1010 from distally advancingwith respect to outer tube 1070. In this position, cover 1010 is in itsdistal-most position where it radially surrounds distal tip 1008 ofneedle 1006 and barbed suture 1002.

In use, in response to at least a partial actuation of the trigger, thedrive rod 150 rotates, as discussed above. Rotation of the drive rodresults in a corresponding rotation of drive element 1050, clutch 1040,and clevis 1030. A predetermined amount of rotation (e.g., about 90° ofclevis 1030 causes flange 1036 of clevis 1030 to rotate in the generaldirection of arrow “FLA” from a first position within cutout 1074 ofouter tube 1070, to a second position where flange 1036 engages alateral wall 1074 a of cutout 1074 of outer tube 1070 (see FIG. 27).Engagement between flange 1036 and lateral wall 1074 a preventscontinued rotation of clevis 1030 with respect to outer tube 1070 in thedirection of arrow “FLA.” Accordingly, when clevis 1030 continues torotate in the direction of arrow “FLA” (e.g., in response to continuedor additional actuation of the trigger), outer tube 1070 also rotates inthe direction of arrow “FLA” with respect to cover 1010.

Rotation of outer tube 1070 in the direction of arrow “FLA” with respectto cover 1010 causes angled slot 1078 of outer tube 1070 to disengagefrom tab 1018 of cover 1010, which causes tab 1018 of cover 1010 to bewithin longitudinal groove 1076 of outer tube 1070. When tab 1018 ofcover 1010 is within longitudinal groove 1076 of outer tube 1070, cover1010 is in an unlocked position.

Next, a user presses a distal tip of surgical device 100 against tissueand/or mesh to emplace barbed suture 1002 at least partially thereinand/or therethrough. More particularly, the user pushes a distal edge1010 a of cover 1010 against the tissue/mesh, which causes cover 1010 tomove proximally with respect to outer tube 1070 against the bias offirst biasing element 1020. As cover 1010 moves proximally, tab 1018 ofcover 1010 travels proximally within longitudinal groove 1076 of outertube 1070. The proximal movement of cover 1010 exposes barbed suture1002 and distal tip 1008 of needle 1006, at least portions of whichextend distally beyond outer tube 1070, and enables barbed suture 1002and distal tip 1008 to penetrate the tissue/mesh.

As the user moves the surgical device 100 proximally (e.g., after barbedsuture 1002 has been emplaced in tissue/mesh), first biasing element1020 urges cover 1010 distally with respect to outer tube 1070. Cover1010 continues to move distally while tab 1018 of cover 1010 travelswithin longitudinal groove 1076 of outer tube 1070 until tab 1018contacts a distal edge 1076 a of longitudinal groove 1076, preventingfurther distal movement of cover 1010 with respect to outer tube 1070(see FIGS. 31 and 32). Further, as tab 1018 of cover 1010 contactsdistal edge 1076 a of longitudinal groove 1076, at least one proximalfinger 1019 of cover 1010 enters an aperture 1071 of outer tube 1070(e.g., in response to a radial outward bias of arms 1014), thuseffectively locking the longitudinal position of cover 1010 with respectto outer tube 1070 (see FIGS. 31 and 33).

Folding Safety Cover

With reference to FIGS. 34-37, a safety cover assembly 2800 for use withvarious end effectors disclosed herein is shown. A cover 2810 of safetycover assembly 2800 is configured to pivot between a first positionwhere safety cover 2800 helps prevent unintentional contact with aneedle 2806 (FIG. 34), and a second position where safety cover 2800allows needle 2806 to be driven into tissue (FIG. 35).

With particular reference to FIG. 37, safety cover assembly 2800includes cover 2810, a drive member 2820, a biasing member 2830, a gear2840, a clutch 2850, and an outer tube 2870. Cover 2810 includes aproximal lip 2812, and an angled blocking portion 2814 (FIG. 36).Proximal lip 2812 is configured to pivotably engage a distal finger 2872of outer tube 2870 to facilitate pivotal movement therebetween. Blockingportion 2814 of cover 2810 is configured to selectively engage a portionof needle 2806 and/or clutch 2850. The engagement between blockingportion 2814 and needle 2806 and/or clutch 2850 restricts the biasingforce supplied by biasing member 2830.

Biasing member 2830 of cover assembly 2800 includes a first portion 2832engaged with (e.g., affixed to) a proximal portion of needle 2086, and asecond portion 2834 engaged with (e.g., affixed to) a proximal portionof cover 2810. Biasing member 2830 is configured to bias cover 2810 awayfrom needle 2806 toward its second position (FIG. 35). As noted above,the engagement between blocking portion 2814 of cover 2810 and needle2806 and/or clutch 2850 resists the biasing force supplied by biasingmember 2830.

Drive member 2820, gear 2840, and clutch 2850 of cover assembly 2800 aredisposed radially within outer tube 2870. Drive member 2820 ismechanically engaged (e.g., operatively coupled, directly affixed, etc.)to drive rod 150 of surgical device 100 of the present disclosure.Accordingly, rotation of the drive rod 150 in the general direction ofarrow “FSA” results in a corresponding rotation of drive member 2820.Additionally, drive member 2820 is configured to engage gear 2840 suchthat rotation of drive member 2820 in the general direction of arrow“FSA” causes a corresponding rotation of gear 2840 in the generaldirection of arrow “FSA.” Further, gear 2840 is configured to engageclutch 2850 such that rotation of gear 2840 in the general direction ofarrow “FSA” causes a corresponding rotation of clutch 2850.

With reference to FIGS. 35-37, clutch 2850 of cover assembly 2800 isconfigured to engage a portion of cover 2810, such that rotation ofclutch 2850 in the general direction of arrow “FSA” causes acorresponding rotation of cover 2810 in the general direction of arrow“FSA.” With particular reference to FIG. 36, rotation of cover 2810 inthe general direction of arrow “FSA” causes blocking portion 2814 ofcover 2810 to rotate with respect to needle 2806, such that blockingportion 2814 no longer resists the force exerted by biasing member 2830onto cover 2810. Accordingly, rotation of drive rod 150 in the generaldirection of arrow “FSA” causes a corresponding rotation of drive member2820, gear 2840, clutch 2850 and cover 2810, thus causing cover 2810 topivot in the general direction of arrow “FSB” (FIG. 35) toward itssecond position, since blocking portion 2814 no longer resists the forceexerted by biasing member 2830 onto cover 2810. Additionally, proximalteeth 2852 of clutch 2850, which mate with distal teeth 2842 of gear2840, are configured to skip following additional rotation of gear 2840after cover 2810 moves toward its second position.

When cover 2810 is in its second position, needle 2806 is exposed and isable to be driven into tissue, for example. If a user desires to movecover 2810 back toward its first position, the user may use a secondaryinstrument or the user's hand, to pivot cover 2810 toward its firstposition against the bias of biasing member 2830. The cover 2810 can berotated in the general direction of arrow “FSC” (FIG. 35) such thatblocking portion 2814 engages needle 2806 and resists the force exertedby biasing member 2830.

Gear Design

Referring now to FIGS. 38-45, an embodiment of an end effector 1200including a gear design assembly is shown. End effector 1200 isconfigured for use in connection with surgical device 100. Generally,end effector 1200 is configured to advance a needle 1206 towards tissue.While FIGS. 38-45 illustrate a particular type of needle 1206, endeffector 1200 may be used with different types of needles.

With particular reference to FIG. 40, end effector 1200 includes a drivegear 1210, a drive shaft 1220, a retraction spring 1230, a guide shaft1240, a deflection member 1250, a proximal support 1260, a distalsupport 1265, and an outer tube 1270.

Drive gear 1210 is mechanically engaged (e.g., operatively coupled,directly affixed, etc.) to drive rod 150 of surgical device 100 of thepresent disclosure. Rotation of drive rod 150 in the general directionof arrow “GDA” in FIG. 41 results in a corresponding rotation of drivegear 1210. Drive gear 1210 includes a plurality of teeth 1212 adjacentits distal end, and is rotationally supported within outer tube 1270.

Drive shaft 1220 includes a proximal portion 1222 including a pluralityof teeth 1224, and an elongated portion 1226 including a helical groove1228 therein. Teeth 1224 are configured to rotationally engage teeth1212 of drive gear 1210, such that rotation of drive gear 1210 in thegeneral direction of arrow “GDA” causes a corresponding rotation ofdrive shaft 1220, depicted by arrow “GDB” in FIG. 42. Elongated portion1226 of drive shaft 1220 is configured to engage a portion of needle1206, such that rotation of elongated portion 1226 causes longitudinaltranslation of needle 1206, as discussed below. Proximal support 1260 ofend effector 1200 engages a portion of drive shaft 1220 to help supportdrive shaft 1220 within outer tube 1270.

Guide shaft 1240 of end effector 1200 is longitudinally and rotationallyfixed within outer tube 1270, and is configured to engage a portion ofneedle 1206 to help guide needle 1206 as needle 1206 travels distallyand proximally with respect to outer tube 1270. A distal portion 1242 ofguide shaft 1240 is supported within outer tube 1270 by engaging distalsupport 1265.

Needle 1206 includes a proximal hub 1206 a, an elongated portion 1206 bextending distally from proximal hub 1206 a, and a distal tip 1206 cconfigured to pierce tissue. Proximal hub 1206 a of needle 1206 includesa first longitudinal groove 1206 aa and a second longitudinal groove1206 ab. First longitudinal groove 1206 aa of proximal hub 1206 a isconfigured to slidably engage guide shaft 1240. Second longitudinalgroove 1206 ab of proximal hub 1206 a is configured to threadedly engagedrive shaft 1220.

Retraction spring 1230 of end effector 1200 is engaged with (e.g.,affixed to) a proximal end of needle 1206 and a portion of drive gear1210. Retraction spring 1230 of end effector 1200 is configured to biasneedle 1206 proximally.

Deflection member 1250 of end effector 1200 extends radially inward froma distal portion of outer tube 1270, and is configured to cause proximalhub 1206 a of needle 1206 to move laterally or radially, as discussedbelow.

Outer tube 1270 of end effector 1200 is configured for positioningradially outward of at least portions of needle 1206, drive gear 1210,drive shaft 1220, retraction spring 1230, guide shaft 1240, proximalsupport 1260, and distal support 1265.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIGS. 41-43, initial rotation of the drive rod 150 resultsin a corresponding rotation of drive gear 1210 of end effector 1200 withrespect to outer tube 1270 in the general direction of arrow “GDA” inFIGS. 41 and 42. Due to the engagement between teeth 1212 of drive gear1210 and teeth 1224 of drive shaft 1220, rotation of drive gear 1210 inthe general direction of arrow “GDA” causes a corresponding rotation ofdrive shaft 1220 in the general direction of arrow “GDB” (see FIG. 42).

Rotation of drive shaft 1220 in the general direction of arrow “GDB”results in distal translation of needle 1206 in the general direction ofarrow “GDC” in FIG. 43. In particular, second longitudinal groove 1206ab of proximal hub 1206 a of needle 1206 includes a pin (not explicitlyshown) extending radially therefrom, which engages helical groove 1228of drive shaft 1220. Accordingly, as drive shaft 1220 rotates, the pinof second longitudinal groove 1206 ab travels within helical groove1228, and thus translates longitudinally. It is also envisioned that inlieu of or in addition to the pin, a thread feature engages helicalgroove 1228. Further, the engagement between first longitudinal groove1206 aa of proximal hub 1206 a of needle 1206 and guide shaft 1240 helpsensure linear and longitudinal movement of needle 1206 with respect toouter tube 1270.

Continued rotation of drive gear 1210 in the general direction of arrow“GDA” causes continued distal advancement of needle 1206 until distaltip 1206 c of needle 1206 extends a sufficient distance distally beyonda distal end of outer tube 1270. After a predetermined amount ofrotation of drive gear 1210 and distal travel of needle 1206 (e.g.,corresponding to when distal tip 1206 c is sufficiently advanced withintissue), proximal hub 1206 a of needle 1206 contacts deflection member1250 (see FIG. 44). The contact or engagement between proximal hub 1206a and deflection member 1250, results in deflection member 1250deflecting proximal hub 1206 a in the general direction of arrow “GDD”in FIG. 44, such that second longitudinal groove 1206 ab of proximal hub1206 a is pushed out of engagement from drive shaft 1220.

Disengagement between second longitudinal groove 1206 ab of proximal hub1206 a and drive shaft 1220 results in the pin of second longitudinalgroove 1206 ab disengaging from helical groove 1228 of drive shaft 1220.Further, since the engagement between the pin and helical groove 1228opposed the proximal force exerted by retraction spring 1230, and sincethe pin is no longer engaged with helical groove 1228, retraction spring1230 pulls needle 1206 proximally in the general direction of arrow“GDE” in FIG. 45, thereby retracting needle 1206. Needle 1206 continuesto retract proximally until it reaches the approximate position shown inFIG. 45.

Outside Tube—Cartridge Design

Referring now to FIGS. 46-56, an embodiment of an end effector 1300including a carriage assembly is shown. End effector 1300 is configuredfor use in connection with surgical device 100. Generally, end effector1300 is configured to advance a needle 1306 towards tissue. While FIGS.46-56 illustrate a particular type of needle 1306, end effector 1300 maybe used with different types of needles.

With particular reference to FIG. 48, end effector 1300 includes a driveassembly 1310, a drive shaft 1320, a retraction spring 1330, a carriage1340, and an outer tube 1370

Drive assembly 1310 of end effector 1300 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to drive rod 150 ofsurgical device 100 of the present disclosure. Rotation of drive rod 150in the general direction of arrow “CAA” in FIG. 49 results in acorresponding rotation of drive shaft 1320.

Drive shaft 1320 of end effector 1300 includes a proximal hub 1322 andan elongated portion 1326 extending distally from proximal hub 1322.Proximal hub 1322 of drive shaft 1320 mechanically engages driveassembly 1310 and is rotationally fixed thereto such that rotation ofdrive assembly 1310 in the general direction of arrow “CAA” results in acorresponding rotation of drive shaft 1320 in the general direction ofarrow “CAA.” Elongated portion 1326 of drive shaft 1320 includes ahelical channel 1328 therein. Elongated portion 1326 is configured toengage a portion of carriage 1340, such that rotation of elongatedportion 1326 causes longitudinal translation of carriage 1340, asdiscussed below.

Needle 1306 includes a recessed portion 1306 a, and a distal tip 1306 bconfigured to pierce tissue. Recessed portion 1306 a is configured toengage a portion of carriage 1340.

Retraction spring 1330 of end effector 1300 is engaged with (e.g.,affixed to) a proximal end of needle 1306 and a portion of driveassembly 1310. Retraction spring 1330 is configured to bias needle 1306proximally.

Outer tube 1370 of end effector 1300 is configured for positioningradially outward of at least portions of needle 1306, drive assembly1310, drive shaft 1320, retraction spring 1330, and carriage 1340. Outertube 1370 includes an elongated slot 1372 configured to slidingly engagea portion of carriage 1340.

Carriage 1340 of end effector 1300 includes a first engagement section1342 configured to engage helical channel 1328 of drive shaft 1320, asecond engagement section 1344 configured to engage recessed portion1306 a of needle 1306, and an extension 1346 configured to slidinglyengage elongated slot 1372 of outer tube 1370. First engagement section1342 includes a length in the longitudinal direction that issubstantially the same as or slightly smaller than a longitudinal length“hc1” (see FIG. 49) of helical channel 1328, thereby facilitating africtional engagement therebetween. Second engagement section 1344 isarcuate, and includes the same or a similar radius of curvature asrecessed portion 1306 a of needle 1306. Second engagement section 1344also includes a length in the longitudinal direction that issubstantially the same as or slightly smaller than a longitudinal length“hcl2” (see FIG. 51) of recessed portion 1306 a. Extension 1346 ofcarriage 1340 extends at least partially within or at least partiallythrough (e.g., radially outward of) elongated slot 1372 of outer tube1370, and is configured to longitudinally travel along elongated slot1372 as carriage 1340 translates distally and proximally with respect toouter tube 1370.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIGS. 49-53, initial rotation of the drive rod 150 resultsin a corresponding rotation of drive assembly 1310 and drive shaft 1320with respect to outer tube 1370 in the general direction of arrow “CAA”in FIGS. 49 and 53. Due to the engagement between helical channel 1328of drive shaft 1320 and first engagement section 1342 of carriage 1340,rotation of drive assembly 1310 and drive shaft 1320 in the generaldirection of arrow “CAA” results in distal translation of carriage 1340,which is guided by the engagement between extension 1346 and elongatedslot 1372.

As carriage 1340 translates distally with respect to outer tube 1370,needle 1306 also travels distally in the general direction of arrow“CAB” in FIG. 53. In particular, the engagement between secondengagement section 1344 of carriage 1340 and recessed portion 1306 a ofneedle 1306 causes needle 1306 to travel distally as carriage 1340travels distally. As noted above, the engagement between extension 1346of carriage 1340 and elongated slot 1372 of outer tube 1370 helps guidethe longitudinal translation of carriage 1340. Thus, rotation of driveassembly 1310 and drive shaft 1320 in the general direction of arrow“CAA” causes distal translation of carriage 1340 and needle 1306 in thegeneral direction of arrow “CAB.”

Continued rotation of drive assembly 1310 and drive shaft 1320 in thegeneral direction of arrow “CAA” causes continued distal advancement ofneedle 1306 until distal tip 1306 b of needle 1306 extends a sufficientdistance distally beyond a distal end of outer tube 1370. Withparticular reference to FIGS. 54-56, after a predetermined amount ofrotation of drive assembly 1310 and drive shaft 1320, and distal travelof needle 1306 (e.g., corresponding to when distal tip 1306 b issufficiently advanced within tissue), carriage 1340 travels distally ofdrive shaft 1320, thus disengaging therefrom. This disengagement betweenfirst engagement section 1342 of carriage 1340 and drive shaft 1320causes carriage 1340 to move laterally, or radially inward, in thegeneral direction of arrow “CAC” in FIG. 54, in response to the naturaldeflection of carriage 1340, for instance. Additionally, with particularreference to FIG. 55, a distal portion of elongated slot 1372 includes aheight “h1” that is greater than a height “h2” of portion of elongatedslot 1372 disposed proximally thereof. The increased height “h1” at thedistal portion of elongated slot 1372 helps prevent extension 1346 orcarriage 1340 from becoming wedged within elongated slot 1372, which mayhinder the lateral movement of carriage 1340 with respect to drive shaft1320. The increased height “h1” also helps allow a greater freedom ofmovement of carriage 1340 after ending its travel with respect to driveshaft 1320, which may also help distal translation of needle 1306.

The lateral movement of carriage 1340 with respect to drive shaft 1320also causes second engagement section 1344 of cartridge 1340 todisengage from recessed portion 1306 a of needle 1306. Since theengagement between carriage 1340 and needle 1306 is opposed the proximalforce exerted by retraction spring 1330, and since the carriage 1340 isno longer engaged with needle 1306, retraction spring 1330 pulls needle1306 proximally in the general direction of arrow “CAD” in FIG. 56,thereby retracting needle 1306. Needle 1306 continues to retractproximally until it reaches the approximate position shown in FIG. 56.

Carriage Driver

Referring now to FIGS. 57-64, an embodiment of an end effector 1400including a carriage assembly is shown. End effector 1400 is configuredfor use in connection with surgical device 100. Generally, end effector1400 is configured to advance a needle 1406 towards tissue. While FIGS.57-64 illustrate a particular type of needle 1406, end effector 1400 maybe used with different types of needles.

With particular reference to FIG. 59, end effector 1400 includes a driveassembly 1410, a helix or coil assembly 1420, a retraction spring 1430,a carriage 1440, a pair of rings, 1450, a distal stop 1460, and an outertube 1470.

Drive assembly 1410 is mechanically engaged (e.g., operatively coupled,directly affixed, etc.) to drive rod 150 of surgical device 100 of thepresent disclosure. Rotation of drive rod 150 in the general directionof arrow “CDA” in FIG. 60 results in a corresponding rotation of driveassembly 1410. Drive assembly 1410 includes a proximal hub 1412 and apair of arms 1414 extending therefrom. Arms 1414 of drive assembly 1410define a pair of slots 1416 therebetween. Slots 1416 are configured toslidingly receive portions of carriage 1440, as discussed below.

Needle 1406 includes a proximal portion 1406 a, and a distal tip 1406 bconfigured to pierce tissue. Proximal portion 1406 a of needle 1406 isconfigured to engage a portion of carriage 1440, as discussed below.

Retraction spring 1430 of end effector 1400 is engaged with (e.g.,affixed to) a proximal end of needle 1406 and a portion of driveassembly 1410. Retraction spring 1430 is configured to bias needle 1406proximally.

With particular reference to FIG. 60, rings 1450 (e.g., O-rings) of endeffector 1400 are positioned radially outward of a proximal portiondrive assembly 1410. Rings 1450 help maintain appropriate spacingbetween drive assembly 1410 and outer tube 1470, and help facilitaterotation of drive assembly 1410 with respect to outer tube 1470.

Outer tube 1470 of end effector 1400 is configured for positioningradially outward of at least portions of needle 1406, drive assembly1410, retraction spring 1430, and carriage 1440. Distal stop 1460 of endeffector 1400 is secured within a distal portion of outer tube 1470, andis configured to prevent carriage 1440 from distally exiting outer tube1470.

Helix or coil assembly 1420 of end effector 1400 extends between aproximal portion of drive assembly 1410 and distal stop 1460, and isdisposed radially within outer tube 1470. Helix or coil assembly 1420 isstationary with respect to outer tube 1470, and is configured to engagea portion of carriage 1440 such that carriage 1440 can movelongitudinally and rotationally within outer tube 1470 and with respectto outer tube 1470.

Carriage 1440 of end effector 1400 is generally eye-lid or ovoid shapedincluding a first lateral portion 1442, a second lateral portion 1444,and defining a central aperture 1446 configured to engage proximalportion 1406 a of needle 1406. It is envisioned that carriage 1440 ismade from a single piece of material, which is folded at one of thefirst lateral portion 1442 (as shown) or second lateral portion 1444.Each of first lateral portion 1442 and second lateral portion 1444 ofcarriage 1440 is configured to slidingly engage slot 1416 of driveassembly 1410. Additionally, first lateral portion 1442 includes a notch1443 therein which is configured to engage helix or coil assembly 1420,and second lateral portion 1444 includes a first leg 1444 a and a secondleg 1444 b. Carriage 1440 is configured to move rotationally andlongitudinally with respect to outer tube 1470.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIGS. 60-63, initial rotation of the drive rod 150 resultsin a corresponding rotation of drive assembly 1410, carriage 1440 andneedle 1406 with respect to outer tube 1470 in the general direction ofarrow “CDA” in FIG. 60. Due to the engagement between helix or coilassembly 1420 and notch 1443 of first lateral portion 1442 of carriage1440, rotation of carriage 1440 in the general direction of arrow “CDA”results in distal translation of carriage 1440 and needle 1406 withrespect to outer tube 1470 in the general direction of arrow “CDB” inFIG. 60. Additionally, the engagement between notch 1443 and helix orcoil assembly 1420 resists the proximal biasing force provided byretraction spring 1430. The distal translation of carriage 1440 isguided by the engagement between first lateral portion 1442 and slot1416, and between second lateral portion 1444 and slot 1416. Thus,rotation of drive assembly 1410 in the general direction of arrow “CDA”causes distal translation of carriage 1440 and needle 1406 in thegeneral direction of arrow “CDB.”

Continued rotation of drive assembly 1410 in the general direction ofarrow “CDA” causes continued distal advancement of needle 1406 untildistal tip 1406 b of needle 1406 extends a sufficient distance distallybeyond a distal end of outer tube 1470. With particular reference toFIG. 64, after a predetermined amount of rotation of drive assembly 1410and distal travel of needle 1406 (e.g., corresponding to when distal tip1406 b is sufficiently advanced within tissue), notch 1443 of carriage1440 is advanced distally beyond helix or coil assembly 1420, andportions of carriage 1440 are distally advanced into a widened portion1417 (see FIGS. 57 and 59) of slot 1416 of drive assembly 1410. In thisposition, carriage 1440 is configured to spring from an approximatedposition, where first leg 1444 a and second leg 1444 b are relativelyclose to each other, toward an open position where first leg 1444 a andsecond leg 1444 b of second lateral portion 1444 are farther apart fromeach other. It is envisioned that carriage 1440 is spring biased intothe open position, cammed into the open position, or otherwise movedtoward the open position.

In the approximated position, a distance 1444 d (FIG. 61) between outeredges of first leg 1444 a and second leg 1444 b is smaller than a width1416 d (FIG. 61) of slot 1416. In the open portion, distance 1444 d isgreater than width 1416 d of slot 1416. Accordingly, in the openposition, carriage 1440 is prevented from moving proximally with respectto outer tube 1470. Additionally, distal stop 1460 prevents carriage1440 from moving distally beyond outer tube 1470, as first lateralportion 1442 and second lateral portion 1444 would contact distal stop1460.

Thus, since the proximal force exerted by retraction spring 1430 is nolonger opposed by the engagement between carriage 1440 and helix or coilassembly 1420, needle 1406 is able to move proximally in the generaldirection of arrow “CDC” until it reaches the approximate position shownin FIG. 64. However, since carriage 1440 is in its open position,engagement between a proximal wall 1417 a (FIG. 59) of widened portion1417 of slot 1416, and first lateral portion 1442 and second lateralportion 1444 of carriage 1440 resists the proximal force exerted byretraction spring 1430, which causes carriage 1440 to remain in theapproximate position shown in FIG. 64. Accordingly, at least a portionof needle 1406 is retracted through aperture 1446 of carriage 1440 afternotch 1443 of carriage 1440 extends beyond helix or coil assembly 1420.

Offset Needle

Referring now to FIGS. 65-70, an embodiment of an end effector 1500including a longitudinally offset needle 1506 is shown. End effector1500 is configured for use in connection with surgical device 100.Generally, end effector 1500 is configured to advance needle 1506towards tissue. While FIGS. 65-70 illustrate a particular type of needle1506, end effector 1500 may be used with different types of needles.

With particular reference to FIG. 66, end effector 1500 includes a driveassembly 1510, a drive shaft 1520, a biasing element 1530, a needle ring1540, a reverse drive unit 1550, a guide bracket 1560, a pair of rings1565, and an outer tube 1570.

Drive assembly 1510 of end effector 1500 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to drive rod 150 ofsurgical device 100 of the present disclosure. Drive assembly 1510includes a proximal portion 1512 and an arm 1514 extending distally fromproximal portion 1512. Arm 1514 of drive assembly 1510 includes a notch1516 disposed on a distal portion thereof. As discussed below, notch1516 is configured to engage a portion of needle ring 1540.

Drive shaft 1520 of end effector 1500 includes a proximal portion 1522and an elongated portion 1524 extending distally from proximal portion1522. Proximal portion 1522 of drive shaft 1520 is configured to engage(e.g., non-rotationally engage) drive assembly 1510, such that rotationof drive assembly 1510 results in a corresponding rotation of driveshaft 1520. Elongated portion 1524 of drive shaft 1520 defines alongitudinal axis “ONAA” disposed at a radial center of end effector1500. Elongated portion 1524 also includes a helical groove 1526therein, which is configured to engage reverse drive unit 1550, asdiscussed below.

Needle 1506 is disposed radially outward of elongated portion 1524 ofdrive shaft 1520, and is thus laterally offset from longitudinal axis“ONAA.” A proximal portion 1506 a of needle 1506 engages (e.g.,frictionally engages) a portion of needle ring 1540, as discussed below.A distal tip 1506 b of needle 1506 is configured to pierce tissue.

Biasing element 1530, e.g., a compression spring, of end effector 1500includes a proximal portion 1532 and a distal portion 1534. Proximalportion 1532 of biasing element 1530 is positioned radially outward ofand in mechanical cooperation (e.g., affixed to) drive assembly 1510(e.g., proximal portion 1512 of drive assembly 1510). Distal portion1534 of biasing element 1530 is disposed proximally of at least aportion of needle ring 1540, and is configured to urge needle ring 1540,and thus needle 1506, distally with respect to outer tube 1570.

Needle ring 1540 of end effector 1500 includes an engagement portion1542 defining a channel 1544, and includes a finger 1546 positionedgenerally opposite engagement portion 1542. Channel 1544 of engagementportion 1542 of needle ring 1540 is configured to engage proximalportion 1506 a of needle 1506, such that needle 1506 is longitudinallyfixed with respect to needle ring 1540, for instance. Finger 1546extends radially inward and is configured for selective engagement bynotch 1516 of arm 1514 of drive assembly 1510.

Reverse drive unit 1550 of end effector 1500 includes an arcuate bodyportion 1552 and a pair of legs 1554 extending generally laterallytherefrom. Body portion 1552 of reverse drive unit 1550 is configured toengage elongated portion 1524 of drive shaft 1520. Legs 1554 of reversedrive unit 1550 are configured to engage or contact an inner wall ofouter tube 1570 to help maintain the lateral position of reverse driveunit 1550 with respect to outer tube 1570. Additionally, reverse driveunit 1550 includes a pin (not explicitly shown) extending generallylaterally from body portion 1552. The pin is configured to slidinglyengage helical groove 1526 of elongated portion 1524 of drive shaft1520, such that rotation of drive shaft 1520 results in longitudinalmovement of reverse drive unit 1550.

Guide bracket 1560 of end effector 1500 is generally shaped similar to aFIG. 8 and/or letter S, and includes a first engagement portion 1562defining a first aperture 1564, and a second engagement portion 1566defining a second aperture 1568. Guide bracket 1560 is positioneddistally of reverse drive unit 1550 and helps maintain the desiredlateral spacing between drive shaft 1520 and needle 1506. First aperture1564 of first engagement portion 1562 is configured to engage a distalportion of drive shaft 1520. Drive shaft 1520 is rotatable with respectto guide bracket 1560, such that rotation of drive shaft 1520 does noteffect the rotational position of guide bracket 1560. Second aperture1568 of second engagement portion 1566 is configured to slidinglyreceive at least a portion of needle 1506 therethrough, such that needle1506 is longitudinally translatable with respect to guide bracket 1560.

Rings 1565 (e.g., O-rings) of end effector 1500 are positioned radiallyoutward of proximal portion 1512 of drive assembly 1510. Rings 1565 helpmaintain appropriate spacing between drive assembly 1510 and outer tube1570, and help facilitate rotation of drive assembly 1510 with respectto outer tube 1570.

Outer tube 1570 of end effector 1500 is configured for positioningradially outward of at least portions of needle 1506, drive assembly1510, drive shaft 1520, biasing element 1530, needle ring 1540, reversedrive unit 1550, guide bracket 1560, and rings 1565.

As shown in FIGS. 65 and 67, prior to use, notch 1516 of drive assembly1510 is in contact with finger 1546 of needle ring 1540. This contactbetween notch 1516 and finger 1546 resists the distal bias of biasingelement 1530, and thus prevents needle 1506 from distally translatingwith respect to outer tube 1570.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIGS. 67-69, rotation of the drive rod 150 results in acorresponding rotation of drive assembly 1510 with respect to outer tube1570. A predetermined amount of rotation (e.g., about 10°) of driveassembly 1510 causes notch 1516 of drive assembly 1510 to rotate in thegeneral direction of arrow “ONA” (FIG. 67) from a first position wherenotch 1516 (or walls defining notch 1516) is in contact with finger 1546of needle ring 1540, to a second position where notch 1516 (or wallsdefining notch 1516) is free from contact with finger 1546. Thedisengagement between notch 1516 and finger 1546 results in finger 1546no longer resisting the distal bias of biasing element 1530, thusresulting in needle 1506 distally translating with respect to outer tube1570 in the general direction of arrow “ONB” in FIG. 67 to the positionshown in FIG. 69 where needle ring 1540 contacts reverse drive unit1550. Thus, to insert needle 1506 into tissue, a distal end of endeffector 1500 is positioned adjacent or in contact with tissue, and thetrigger of surgical device 100 is at least partially actuated, thusdistally advancing a portion of needle 1506 into tissue.

As described above, rotation of drive assembly 1510 of end effector 1500results in a corresponding rotation of drive shaft 1520. Additionally,due to the engagement between reverse drive unit 1550 and helical groove1526 of drive shaft 1520, rotation of drive shaft 1520 in the generaldirection of arrow “ONA” results in reverse drive unit 1550 movingproximally in the general direction of arrow “ONC” (FIGS. 69 and 70)with respect to drive shaft 1520. This proximal movement of reversedrive unit 1550 causes a corresponding proximal movement of needle ring1540 and needle 1506 due to the engagement between reverse drive unit1550 and needle ring 1540.

Continued or additional actuation of the trigger of surgical device 100results in reverse drive unit 1550 reaching its proximal-most position,as shown in FIG. 70, where needle 1506 is positioned such that distaltip 1506 b thereof is longitudinally aligned with or proximal of adistal end of outer tube 1570, thereby reducing the possibility of auser unintentionally contacting needle 1506.

Further, the rotation of drive assembly 1510 (e.g., in response tocontinued actuation or an additional actuation of trigger) results innotch 1516 of arm 1514 re-engaging finger 1546 of needle ring 1540.Here, a second distal advancement of needle 1506 with respect to outertube 1570 is prevented due to the engagement between needle ring 1540and reverse drive unit 1550 (FIG. 70). Moreover, the engagement betweenreverse drive unit 1550 and helical groove 1526 prevents distal movementof reverse drive unit 1550 with respect to drive shaft 1520.

Spring Return “A”

Referring now to FIGS. 71-76, an embodiment of an end effector 1700 isshown. End effector 1700 is configured for use in connection withsurgical device 100. Generally, end effector 1700 is configured toadvance a needle 1706 towards tissue and to eject a barbed suture 1702towards tissue. While FIGS. 71-76 illustrate a particular type of barbedsuture 1702 and a particular type of needle 1706, end effector 1700 maybe used with different types of sutures and/or needles.

With particular reference to FIG. 72, end effector 1700 includes a driveassembly 1710, a driver 1720, a retraction spring 1730, a helix or coilassembly 1740, a pair of rings 1750, and an outer tube 1770.

Drive assembly 1710 of end effector 1700 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to a drive rod assembly1780 of the handle assembly of the surgical device 100 of the presentdisclosure. Rotation of drive rod assembly 1780 in the general directionof arrow “SRA” in FIG. 73 results in a corresponding rotation of driveassembly 1710. Drive assembly 1710 includes a proximal hub 1712 and apair of arms 1714 extending therefrom. Arms 1714 of drive assembly 1710define a pair of slots 1716 therebetween. Slots 1716 are configured toslidingly receive portions of driver 1720.

Needle 1706 includes a proximal hub 1706 a, and a distal tip 1706 bconfigured to pierce tissue. Needle 1706 also includes a lip 1706 cdisposed distally of proximal hub 1706 a. Lip 1706 c is configured toengage a portion of driver 1720, as discussed below.

Retraction spring 1730 of end effector 1700 is engaged with (e.g.,affixed to) a proximal end of needle 1706 and a portion of driveassembly 1710. Retraction spring 1730 is configured to bias needle 1706proximally.

With particular reference to FIGS. 71 and 73, rings 1750 (e.g., O-rings)of end effector 1700 are positioned radially outward of a proximalportion drive assembly 1710. Rings 1750 help maintain appropriatespacing between drive assembly 1710 and outer tube 1770, and helpfacilitate rotation of drive assembly 1710 with respect to outer tube1770.

Helix or coil assembly 1740 of end effector 1700 extends between aproximal portion of drive assembly 1410 and a distal portion of outertube 1770, and is disposed radially within outer tube 1770. Helix orcoil assembly 1740 is stationary with respect to outer tube 1770, and isconfigured to engage a portion of driver 1720 such that driver 1720 canmove longitudinally and rotationally within outer tube 1770 and withrespect to outer tube 1770.

With particular reference to FIG. 74, driver 1720 of end effector 1700includes a proximal portion 1722 and a pair of arms 1724 extendingdistally from proximal portion 1722. Arms 1724, including a first arm1724 a and a second arm 1724 b, are biased radially outwardly in thegeneral direction of arrow “SRB” in FIG. 75. Engagement between arms1724 and outer tube 1770 prevent arms 1724 from moving radially out ofengagement with needle 1706. Driver 1720 defines a cavity 1721 (FIG. 72)therein, which is configured to releasably retain proximal hub 1706 a ofneedle 1706 therein. Driver 1720 further includes a plurality of threads1726 extending radially outward from proximal portion 1722 and/or atleast one arm 1724. Threads 1726 are configured to engage helix or coilassembly 1740 (e.g., distal edges of helix or coil assembly 1740). Inthe illustrated embodiment, driver 1720 includes a first thread 1726 aextending radially outward from proximal portion 1722, a second thread1726 b extending radially outward from first arm 1724 a, and a thirdthread 1726 c extending radially outward from a distal portion of secondarm 1724 b. Proximal portions of threads 1726 are generally arcuate forengaging with helix or coil assembly 1740. A distal face 1726 ca ofthird thread 1726 c is generally perpendicular to needle 1706.

Driver 1720 also includes a finger 1727 extending radially outward fromthe arm that does not include a thread at its distal portion. In theillustrated embodiment, first arm 1724 a of arms 1724 of end effector1700 includes finger 1727. A distal face 1727 a of finger 1727 isgenerally perpendicular to needle 1706 and generally parallel to distalface 1726 ca of third thread 1726 c. As shown in FIG. 74, distal face1726 ca of third thread 1726 c and distal face 1727 a of finger 1727 areeach configured to mechanically engage a proximal surface of lip 1706 cof needle 1706.

With particular reference to FIG. 73, driver 1720 of end effector 1700further includes tabs 1728 disposed adjacent a distal end of each arm1724. Tabs 1728 extend radially inward from the respective arm 1724, andare each configured to engage a recess 1706 d of needle 1706. Recesses1706 d of needle 1706 are disposed between proximal hub 1706 a and lip1706 c of needle 1706. Driver 1720 is rotatable with respect to needle1706.

Outer tube 1770 of end effector 1700 is configured for positioningradially outward of at least portions of needle 1706, drive assembly1710, driver 1720, retraction spring 1730, and helix or coil assembly1740. Outer tube 1770 includes a pair of apertures 1772 disposedadjacent its distal end. Each aperture 1772 is configured to engage(e.g., releasably engage) one of third thread 1726 c or finger 1727 ofdriver 1720.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod assembly 1780 rotates, as discussedabove. With reference to FIGS. 73-76, initial rotation of the drive rodassembly 1780 results in a corresponding rotation of drive assembly 1710and driver 1720 of end effector 1700 with respect to outer tube 1770 inthe general direction of arrow “SRA” in FIG. 73. Due to the engagementbetween helix or coil assembly 1740 and fingers 1726 of driver 1720,rotation of driver 1720 in the general direction of arrow “SRA” resultsin a corresponding rotation and distal translation of driver 1720 withrespect to outer tube 1770 in the general direction of arrow “SRC” inFIG. 73. Distal translation of driver 1720 causes a corresponding distaltranslation of needle 1706. Additionally, since driver 1720 is rotatablewith respect to needle 1706, rotation of driver 1720 does not causerotation of needle 1706.

Continued rotation of drive assembly 1710 in the general direction ofarrow “SRA” causes continued distal advancement of driver 1720 andneedle 1706 until distal tip 1706 b of needle 1706 extends a sufficientdistance distally beyond a distal end of outer tube 1770. Thus, toinsert needle 1706 and/or barbed suture 1702 into tissue, a distal endof end effector 1700 is positioned adjacent or in contact with tissue,and the trigger of surgical device 100 is at least partially actuated,thus distally advancing a portion of needle 1706 and/or barbed suture1702 into tissue.

With particular reference to FIGS. 75 and 76, after a predeterminedamount of rotation of drive assembly 1710 of end effector 1700 anddistal travel of needle 1706 (e.g., corresponding to when distal tip1706 b is sufficiently advanced within tissue), fingers 1726 of driver1720 are advanced distally beyond helix or coil assembly 1710. In thisposition, third thread 1726 c and finger 1727 of driver 1720 are axiallyaligned with apertures 1772 of outer tube 1770. Here, outer tube 1770 nolonger resists the radially outward bias of arms 1724 of driver 1720,thus permitting arms 1724 to flex radially outward in the direction of“SRB” in FIG. 75 such that third thread 1726 c and finger 1727 engageapertures 1772, which causes driver 1720 to stop moving distally withrespect to outer tube 1770.

Further, the radially outward movement of arms 1724 causes tabs 1728 ofdriver 1720 of end effector 1700 to disengage recess 1706 d of needle1706. Thus, since the proximal force exerted by retraction spring 1730of end effector 1700 is no longer opposed by the engagement betweendriver 1720 and needle 1706, needle 1706 is able to move proximally inthe general direction of arrow “SRD” until needle 1706 reaches theapproximate position shown in FIG. 76. Since driver 1720 is engaged withapertures 1772 of outer tube 1770 and is no longer mechanically engagedwith needle 1706, the proximal movement of needle 1706 causes at least aportion of needle 1706 to move through cavity 1721 of driver 1720, whiledriver 1720 remains adjacent a distal portion of outer tube 1770, asshown in FIG. 76.

It is envisioned that end effector 1700 can be used more than once.After its initial use, as described above, a user can manually pullneedle 1706 distally (e.g., using a pliers-like tool) until recess 1706d of needle 1706 is axially aligned with tabs 1728 of driver 1720. Inthis position, while needle 1706 is being maintained in its longitudinalposition, a user can manually move arms 1724 of driver 1720 radiallyinwardly by exerting an appropriate force (e.g., through apertures 1772)on third thread 1726 c and finger 1727 to cause tabs 1728 to engagerecess 1706 d. Here, the proximal force exerted by retraction spring1730 causes both needle 1706 and driver 1720 to move proximally to theirinitial positions such that end effector 1700 can be used again toadvance needle 1706. Additionally, if a user wishes to use anotherbarbed suture 1702, needle 1706 can be pulled farther proximally toallow an additional barbed suture 1702 to engage needle 1706 prior todriver 1720 re-engaging needle 1706.

Lead Screw Spring Clip

Referring now to FIGS. 77-82, an embodiment of an end effector 2000including a pre-loaded spring assembly is shown. End effector 2000 isconfigured for use in connection with surgical device 100. Generally,end effector 2000 is configured to advance a needle 2006 towards tissue.While FIGS. 77-82 illustrate a particular type of needle 2006, endeffector 2000 may be used with different types of needles.

With particular reference to FIG. 78, end effector 2000 includes a driveassembly 2010, a driver 2020, a biasing element or retraction spring2030, a clip assembly 2040, a needle assembly 2050, pins 2065, and anouter tube 2070.

Drive assembly 2010 of end effector 2000 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to drive rod 150 ofsurgical device 100 of the present disclosure. Rotation of the drive rodassembly in the general direction of arrow “LSA” in FIG. 80 results in acorresponding rotation of drive assembly 2010. Drive assembly 2010includes a proximal hub 2012, a groove 2014 and a lateral aperture 2016,and defines a cavity 2018 extending at least partially therethrough.Groove 2014 is configured to engage pins 2065, which facilitates therotation of drive assembly 2010 with respect to outer tube 2070, andwhich prevents or limits longitudinal translation therebetween. Lateralaperture 2016 of drive assembly 2010 is configured to receive a portionof a pin 2015; pin 2015 also extends at least partially through anaperture 2022 of driver 2020, as discussed below. Cavity 2018 of driveassembly 2010 is configured to receive a proximal portion 2024 of driver2020, as discussed below.

Driver 2020 of end effector 2000 includes an aperture 2022, a proximalportion 2024, and a body portion 2026 including a helical groove 2028.Proximal portion 2024 of driver 2020 has a smaller diameter than bodyportion 2026 and is configured to slidingly engage cavity 2018 of driveassembly 2010. When proximal portion 2024 is engaged with cavity 2018,and when aperture 2022 of driver 2020 is rotationally aligned withlateral aperture 2016 of drive assembly 2010, pin 2015 is insertablethrough lateral aperture 2016 and aperture 2022 to prevent or limitrotational movement and longitudinal movement between drive assembly2010 and driver 2020.

Retraction spring 2030 of end effector 2000 is engaged with (e.g.,hooked on) a proximal end of needle assembly 2050 and a pin 2072extending through outer tube 2070 and through a portion of clip assembly2040 (see FIG. 77). Retraction spring 2030 is configured to bias needleassembly 2050 proximally.

Clip assembly 2040 of end effector 2000 includes a proximal portion2042, a body portion 2044, and a pair of arms 2046 extending distallyfrom body portion 2044. Proximal portion 2042 of clip assembly 2040 isconfigured to engage driver 2020. In particular, proximal portion 2042of clip assembly 2040 is positionable radially outward of driver 2020and includes an engagement structure 2043 configured to engage helicalgroove 2028 of driver 2020. While engagement structure 2043 isillustrated as a helical thread, engagement structure 2043 may also be apin or the like. Due to the engagement between proximal portion 2042 andhelical groove 2028 of driver 2020, rotation of driver 2020 results inlongitudinal translation of proximal portion 2042.

Body portion 2044 of clip assembly 2040 is mechanically engaged withproximal portion 2042, and includes a pair of longitudinal slots 2045 a,2045 b extending therethrough. Slots 2045 a, 2045 b are configured toslidingly receive pin 2072, such that pin 2072 helps guide longitudinaltranslation of body portion 2042 with respect to pin 2072 and outer tube2070. Body portion 2044 also includes recessed or flattened portions2047 for engaging a proximal portion of each arm 2046. It is envisionedthat proximal portions of arms 2046 are rigidly affixed to flattenedportions 2047 of body portion 2044.

Arms 2046 of clip assembly 2040 extend distally from body portion 2044.Each arm 2046 includes a finger 2049 adjacent a distal portion thereof.Fingers 2049 are configured to releasably engage a portion of needleassembly 2050, as discussed below. At least portions of arms 2046 (e.g.,fingers 2049) are biased radially outwardly in the general direction ofarrow “LSC” in FIG. 81 into contact with outer tube 2070, for example.Engagement between fingers 2049 and outer tube 2070 prevent fingers 2049from moving radially out of engagement with needle assembly 2050.

Needle assembly 2050 is configured to hold or releasably hold needle2006 or a portion of needle 2006. In embodiments, needle assembly 2050includes a distal recess 2052 for engaging needle 2006. Additionally,needle assembly 2050 includes a proximal portion 2054 configured toengage a distal portion of retraction spring 2030. Needle assembly 2050also includes a pair of distal lips 2056, which are each configured toengage a respective finger 2049 of arms 2046 of clip assembly 2040. Theengagement between fingers 2049 and distal lips 2056 resists theproximal force exerted on needle assembly 2050 by retraction spring2030.

Outer tube 2070 of end effector 2000 is configured for positioningradially outward of at least portions of needle 2006, drive assembly2010, driver 2020, retraction spring 2030, clip assembly 2040, andneedle assembly 2050. Outer tube 2070 includes a pair of apertures 2074disposed adjacent its distal end. Each aperture 2074 is configured toengage (e.g., releasably engage) portions of fingers 2049 of arms 2046of clip assembly 2040 (see FIGS. 81 and 82).

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIGS. 79-82, initial rotation of the drive rod 150 resultsin a corresponding rotation of drive assembly 2010 and driver 2020 withrespect to outer tube 2070 in the general direction of arrow “LSA” inFIG. 80. Due to the engagement between helical groove 2028 of driver2020 and engagement structure 2043 of clip assembly 2040, rotation ofdriver 2020 in the general direction of arrow “LSA” results in distaltranslation of clip assembly 2040 with respect to outer tube 2070 in thegeneral direction of arrow “LSB” in FIG. 80. Distal translation of clipassembly 2040 causes a corresponding distal translation of needleassembly 2050 and needle 2006.

Continued rotation of drive assembly 2010 in the general direction ofarrow “LSA” causes continued distal advancement of driver clip assembly2040, needle assembly 2050, and needle 2006 until a distal tip 2006 a ofneedle 2006 extends a sufficient distance distally beyond a distal endof outer tube 2070. Thus, to insert needle 2006 into tissue, a distalend of end effector 2000 is positioned adjacent or in contact withtissue, and the trigger of surgical device 100 is at least partiallyactuated, thus distally advancing a portion of needle 2006 into tissue.

With particular reference to FIGS. 81 and 82, after a predeterminedamount of rotation of drive assembly 2010 and distal travel of clipassembly 2040, needle assembly 2050, and needle 2006 (e.g.,corresponding to when distal tip 2006 a is sufficiently advanced withintissue), fingers 2049 of arms 2046 of clip assembly 2040 are advanceddistally until fingers 2049 are axially aligned with apertures 2074 ofouter tube 2070. Here, outer tube 2070 no longer resists the radiallyoutward bias of arms 2046, thus permitting arms 2046 to flex radiallyoutward in the direction of “LSC” in FIG. 81 such that fingers 2049engage apertures 2074, which causes clip assembly 2040, needle assembly2050, and needle 2006 to stop moving distally with respect to outer tube2070.

Further, the radially outward movement of arms 2046 causes fingers 2049to disengage distal lips 2056 of needle assembly 2050. Thus, since theproximal force exerted by retraction spring 2030 is no longer opposed bythe engagement between clip assembly 2040 and needle assembly 2050,needle assembly 2050 is able to move proximally in the general directionof arrow “LSD” until needle 2006 reaches the approximate position shownin FIG. 82.

It is envisioned that end effector 2000 can be used more than once.After its initial use, as described above, a user can manually pullneedle 2006, and thus needle assembly 2050, distally (e.g., using apliers-like tool) until distal lips 2056 of needle assembly 2050 aredisposed distally fingers 2049. In this position, while needle 2006 isbeing maintained in its longitudinal position, a user can manually movearms fingers 2049 of clip assembly 2040 radially inwardly by exerting anappropriate force (e.g., through apertures 2074) on fingers 2049 tocause each finger 2049 to engage a distal lip 2056. Here, the proximalforce exerted by retraction spring 2030 causes both needle 2006, needleassembly 2050 and clip assembly 2040 to move proximally to their initialpositions such that end effector 2000 can be used again to advanceneedle 2006.

Helix Drive Drop Tab

Referring now to FIGS. 83-90, an embodiment of an end effector 2500 isshown. End effector 2500 is configured for use in connection withsurgical device 100. Generally, end effector 2500 is configured toadvance a needle 2506 towards tissue and to eject a barbed suture 2502towards tissue. While FIGS. 83-90 illustrate a particular type of barbedsuture 2502 and a particular type of needle 2506, end effector 2500 maybe used with different types of sutures and/or needles.

With particular reference to FIG. 84, end effector 2500 includes a driveassembly or drive shaft 2510, a driver 2520, a retraction spring 2530, aproximal ring 2540, a tab 2550, and an outer tube 2570.

Drive shaft 2510 of end effector 2500 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to drive rod 150 ofsurgical device 100 of the present disclosure. Rotation of the drive rodassembly in the general direction of arrow “HDA” in FIG. 85 results in acorresponding rotation of drive shaft 2510. Drive shaft 2510 includes aproximal hub 2512, a helical groove 2514, and defines a cavity 2516defined within a distal end of drive shaft 2510 and extending proximallythrough at least a portion of a length of drive shaft 2510 (see FIGS. 85and 86, for example). Helical groove 2514 of drive shaft 2510 isconfigured to engage tab 2550, such that rotation of drive shaft 2510causes tab 2550 to travel at least partially along helical groove 2514.Cavity 2516 of drive shaft 2510 is configured to receive at least aportion of retraction spring 2530 therein.

Driver 2520 of end effector 2500 is a generally hollow cylinder and isconfigured to be positioned radially outward of at least portions ofdrive shaft 2520. Driver 2520 includes a body portion 2521, a slot 2522disposed adjacent a proximal end of body portion 2521 and extending atleast partially through a wall of body portion 2521, a proximal aperture2524, bosses 2526, and a distal aperture 2528. Slot 2522 of driver 2520is arcuate-shaped in a manner that substantially matches a section ofhelical groove 2514 of drive shaft 2510. Slot is 2522 is configured toreleasably retain a portion of tab 2550 therein. Proximal aperture 2524of driver 2520 is configured to allow drive shaft 2520 and retractionspring 2530 to pass at least partially therethrough. Bosses 2526 ofdriver 2520 extend radially outward from body portion 2521 and areconfigured to slidingly engage a longitudinal slot 2572 of outer tube2570. The engagement between bosses 2526 and longitudinal slot 2572helps facilitate and guide longitudinal movement of driver 2520 withrespect to outer tube 2570, which helping to restrict the rotationalmovement of driver 2520 with respect to outer tube 2570. While twobosses 2526 are illustrated, more or fewer bosses 2526 may be utilized.Distal aperture 2528 of driver 2520 is configured to engage a proximalportion of needle 2506.

A proximal portion of retraction spring 2530 of end effector 2500extends through cavity 2516 and is mechanically engaged with drive shaft2510. A distal portion of retraction spring 2530 is engaged with (e.g.,hooked on) a proximal end of needle 2506 and/or driver 2520. Retractionspring 2530 is configured to bias needle 2506 proximally with respect toouter tube 2570.

Proximal ring 2540 of end effector 2500 is disposed about a proximal endof drive shaft 2510 and is configured to facilitate rotation betweendrive shaft 2510 and outer tube 2570.

Outer tube 2570 of end effector 2500 is configured for positioningradially outward of at least portions of barbed suture 2502, needle2506, drive shaft 2510, driver 2520, retraction spring 2530, andproximal ring 2540. Outer tube 2570 includes longitudinal slot 2572configured to slidingly receive bosses 2526 of driver 2520.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIGS. 85-87, initial rotation of the drive rod 150 resultsin a corresponding rotation of drive shaft 2510 with respect to outertube 2570 in the general direction of arrow “HDA” in FIG. 85. Due to theengagement between helical groove 2514 of drive shaft 2510 and tab 2550,rotation of drive shaft 2510 in the general direction of arrow “HDA”results in distal translation of tab 2550 within helical groove 2514 andwith respect to drive shaft 2510. Since tab 2550 is non-rotatablyengaged with driver 2520, and since driver 2520 is rotatably fixed withrespect to outer tube 2570 due to the engagement between bosses 2526 andlongitudinal slot 2572, the distal translation of tab 2550 results indistal translation of driver 2520 with respect to outer tube 2570 towardthe position shown in FIGS. 86 and 87, for example. The engagementbetween tab 2550, drive shaft 2510 and driver 2520 opposes the proximalforce exerted by retraction spring 2530.

Continued rotation of drive shaft 2510 in the general direction of arrow“HDA” causes continued distal advancement of tab 2550, driver 2520,needle 2506 and barbed suture 2502 until a distal tip 2506 a of needle2506 extends a sufficient distance distally beyond a distal end of outertube 2570. Thus, to insert needle 2506 into tissue, a distal end of endeffector 2500 is positioned adjacent or in contact with tissue, and thetrigger of surgical device 100 is at least partially actuated, thusdistally advancing a portion of needle 2506 and/or barbed suture 2502into tissue.

With particular reference to FIGS. 88-90, after a predetermined amountof rotation of drive shaft 2510 and distal travel of tab 2550, driver2520, needle 2506 and/or barbed suture 2502 (e.g., corresponding to whendistal tip 2506 a of needle 2506 is sufficiently advanced withintissue), tab 2550 has travelled through a distal-most end of helicalgroove 2514 and is located distally beyond a distal edge of driver 2510.Here, as shown in FIG. 89, driver 2510 is no longer restricting themovement of tab 2550. This results in tab 2550 moving radially inward ofwalls of driver 2510 (e.g., due to gravity or biased out of thread) inthe general direction of arrow “HDC” and thus out of engagement withdriver 2510. Here, tab 2550 is no longer helping to resist the proximalforced exerted by retraction spring 2530.

Thus, since the proximal force exerted by retraction spring 2530 is nolonger opposed by the engagement between tab 2550, drive shaft 2510 anddriver 2520, needle 2506 is able to move proximally in the generaldirection of arrow “HDD” until needle 2506 reaches the approximateposition shown in FIG. 90. As shown, barbed suture 2502 remains externalof end effector 2500 (e.g., at least partially within tissue).

Spring Return “C”

Referring now to FIGS. 91-98, an embodiment of an end effector 2600 isshown. End effector 2600 is configured for use in connection withsurgical device 100. Generally, end effector 2600 is configured toadvance a needle 2606 towards tissue and to eject a barbed suture (notexplicitly shown) towards tissue. While FIGS. 91-98 illustrate aparticular type of needle 2606, end effector 2600 may be used withdifferent types of needles.

With particular reference to FIG. 92, end effector 2600 includes a driveassembly 2610, a needle assembly or needle block 2620, a retractionspring 2630, a driver 2640, a pair of rings 2650, and an outer tube2670.

Drive assembly 2610 of end effector 2600 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to drive rod 150 ofsurgical device 100 of the present disclosure. Rotation of the drive rod150 in the general direction of arrow “SRCA” in FIG. 91 results in acorresponding rotation of drive assembly 2610. Drive assembly 2610includes a body portion 2612 and a pair of arms 2614 extendingtherefrom. Arms 2614 of drive assembly 2610 are configured to slidinglyreceive portions of needle block 2620.

Needle block 2620 of end effector 2600 includes a body portion 2622having a pair of longitudinal slots 2624. Each longitudinal slot 2624 isconfigured to slidingly receive one arm 2614 of drive assembly 2610therein. Accordingly, needle block 2620 is longitudinally translatablewith respect to drive assembly 2610. Additionally, the engagementbetween arms 2614 of drive assembly 2610 and longitudinal slots 2624 ofneedle block 2620 causes needle block 2620 to rotate in a correspondingmanner as drive assembly 2610. Needle block 2620 also includes aproximal portion 2626 configured to engage a distal portion ofretraction spring 2630, and defines an aperture 2628 configured toengage a portion of needle 2606. It is envisioned that needle block 2620is neither rotatable nor longitudinally translatable with respect toneedle 2606 due to the engagement therebetween.

A pin 2660 of end effector 2600 extends through an aperture 2621 ofneedle block 2620. Pin 2660 is wider or longer than a width of needleblock 2620 such that pin 2660 extends laterally beyond walls of needleblock 2620. Further, pin 2660 is positioned such that pin 2660 extendslaterally beyond both walls of needle block 2620 to engage portions ofdriver 2640, as discussed below. Additionally, pin 2660 is positionedproximally of needle 2606, and may be positioned in contact with needle2606.

Driver 2640 of end effector 2600 is generally hollow and includes a bodyportion 2642, a pair of longitudinal slots 2644 extending along amajority of a length of body portion 2642, a threaded portion or helixportion 2646 extending radially outward from body portion 2642, and adistal guide 2648. Distal guide 2648 of driver 2640 includes arcuateportions configured to releasably receive portions of pin 2660. Pin 2660is positioned in contact with distal guide 2648 in such a manner thatrotation of pin 2660 causes rotation of driver helix 2648. Additionally,longitudinal slots 2644 of driver 2640 are configured to allow pin 2660to longitudinally travel therethrough. Helix portion 2646 of driver 2640is configured to engage a threaded portion or helical recess 2672disposed in outer tube 2670, such that driver 2640 is rotatable withrespect to outer tube 2670.

A proximal portion of retraction spring 2630 of end effector 2600 ismechanically engaged with drive assembly 2610, and a distal portion ofretraction spring 2630 is mechanically engaged with proximal portion2626 of needle block 2620. Retraction spring 2630 is configured toproximally bias needle block 2620, and thus needle 2606, with respect toouter tube 2670.

Outer tube 2670 of end effector 2600 is configured for positioningradially outward of at least portions of needle 2606, drive assembly2610, needle block 2620, retraction spring 2630, and driver 2640. Outertube 2670 includes helical recess 2672 defined therein, which isconfigured to rotationally engage helix portion 2646 of driver 2640.Driver 2640 is configured to longitudinally translatable with respect toouter tube 2670 in response to rotation of driver 2640 with respect toouter tube 2670. That is, as driver 2640 rotates with respect to outertube 2670, the engagement between helix portion 2646 and helical recess2672 cause driver 2640 to rotate. Additionally, the engagement betweendistal guide 2648 and pin 2660 resists the proximal force exerted byretraction spring 2630. Outer tube 2670 also includes a stop 2674extending radially inward from a distal portion thereof. Stop 2674 isconfigured to selectively engage pin 2660, as discussed below.

Rings 2650 (e.g., O-rings) of end effector 2600 are positioned radiallyoutward of a proximal portion of drive assembly 2610. Rings 2650 helpmaintain appropriate spacing between drive assembly 2610 and outer tube2670, and help facilitate rotation of drive assembly 2610 with respectto outer tube 2670.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIG. 91, initial rotation of the drive rod 150 results in acorresponding rotation of drive assembly 2610 with respect to outer tube2670 in the general direction of arrow “SRCA” in FIG. 91. Due to theengagement between arms 2614 of drive assembly 2610 and longitudinalslots 2624 of needle block 2620, rotation of drive assembly 2610 in thegeneral direction of arrow “SRCA” results in a corresponding rotation ofneedle block 2620. Due to the engagement between pin 2660 and needleblock 2620, and between pin 2660 and distal guide 2648 of driver 2640,rotation of needle block 2620 results in a corresponding rotation ofdriver 2640 with respect to outer tube 2670.

Further, as driver 2640 rotates with respect to outer tube 2670, theengagement between helix portion 2646 and helical recess 2672 of outertube 2670 causes driver 2640 to distally translate with respect to outertube 2670 in the general direction of arrow “SRCB” in FIG. 91. Due tothe engagement between driver 2640 and needle block 2620 via pin 2660,distal translation of driver 2640 results in a corresponding distaltranslation of needle block 2620 and needle 2606.

Continued rotation of drive assembly 2610 in the general direction ofarrow “SRCA” causes continued distal advancement of needle block 2620and needle 2606 until a distal tip 2606 b of needle 2606 extends asufficient distance distally beyond a distal end of outer tube 2670 asshown in FIGS. 94-96, for example. Thus, to insert needle 2606 and/or abarbed suture into tissue, a distal end of end effector 2600 ispositioned adjacent or in contact with tissue, and the trigger ofsurgical device 100 is at least partially actuated, thus distallyadvancing a portion of needle 2606 and/or barbed suture into tissue.

With particular reference to FIG. 93, after a predetermined amount ofrotation of drive assembly 2610 and distal travel of needle 2606 (e.g.,corresponding to when distal tip 2606 b is sufficiently advanced withintissue), pin 2660 contacts stop 2674 of outer tube 2670. In connectionwith rotation of needle block 2620, the contact between pin 2660 andstop 2674 of outer tube 2670 causes pin driver 2640 to rotate withrespect to pin 2660 such that pin 2660 moves out of engagement withdistal guide 2648 until pin 2660 is rotationally aligned withlongitudinal slots 2644 of driver 2640.

In this position, the engagement between pin 2660 and distal guide 2648is no longer resisting the proximal bias provided by retraction spring2630, and pin 2660 is able to proximally translate through longitudinalslots 2644. Accordingly, retraction spring 2630 pulls needle block 2620,pin 2660 and needle 2606 proximally with respect to outer tube 2670 inthe general direction of arrow “SRCC” in FIG. 97.

Spring Return “B”

Referring now to FIGS. 99-103, an embodiment of an end effector 2100 isshown. End effector 2100 is configured for use in connection withsurgical device 100. Generally, end effector 2100 is configured toadvance a needle 2106 towards tissue and to eject a barbed suture 2102towards tissue. While FIGS. 99-103 illustrate a particular type ofbarbed suture 2102 and a particular type of needle 2106, end effector2100 may be used with different types of sutures and/or needles.

With particular reference to FIG. 100, end effector 2100 includes adrive assembly 2110, a driver 2120, a retraction spring 2130, and anouter tube 2170.

Drive assembly 2110 of end effector 2100 is mechanically engaged (e.g.,operatively coupled, directly affixed, etc.) to drive rod 150 ofsurgical device 100 of the present disclosure. Rotation of the drive rod150 in the general direction of arrow “SBA” in FIG. 102 results in acorresponding rotation of drive assembly 2110. Drive assembly 2110includes a body portion 2112 and a pair of arms 2114 extendingtherefrom. Arms 2114 of drive assembly 2110 define a pair of slots 2116therebetween. Slots 2116 of arms 2114 of drive assembly 2110 areconfigured to slidingly receive portions of driver 2120.

Needle block or needle 2106 includes a proximal hub 2106 a, and a distaltip 2106 b configured to pierce tissue. Needle 2106 also includes a lip2106 c disposed distally of proximal hub 2106 a. Lip 2106 c isconfigured to engage a portion of driver 2120, as discussed below.Additionally, needle 2106 includes a hook 2016 d extending proximallyfrom proximal hub 2106 a. Hook 2016 d is configured to engage a distalportion of retraction spring 2130, as discussed below.

A distal portion of retraction spring 2130 of end effector 2100 isengaged with hook 2016 d of needle 2106, and a proximal portion ofretraction spring 2130 is engaged with a pin 2132 extending through anaperture of drive assembly 2110. Retraction spring 2130 is configured tobias needle 2106 proximally.

Driver 2120 of end effector 2100 includes a proximal portion 2122 and apair of arms 2124 extending distally from proximal portion 2122. Arms2124 of driver 2120, including a first arm 2124 a and a second arm 2124b, are biased radially outwardly in the general direction of arrow “SBB”in FIG. 103. Engagement between arms 2124 and outer tube 2170 preventarms 2124 from moving radially out of engagement with needle 2106.Driver 2120 defines a cavity 2121 (FIG. 100) therein, which isconfigured to releasably retain proximal hub 2106 a of needle 2106therein. Driver 2120 further includes a threaded portion including aplurality of threads 2126 extending radially outward from proximalportion 2122 and/or at least one arm 2124. Threads 2126 are configuredto engage a threaded portion or outer threads 2140 (e.g., distal edgesof outer threads 2140), which extend radially inward from an inner wall2171 of outer tube 2170. In the illustrated embodiment, driver 2120includes a first thread 2126 a extending radially outward from secondarm 2124 b, a second thread 2126 b extending radially outward from firstarm 2124 a, and a third thread 2126 c extending radially outward from adistal portion of second arm 2124 b. Proximal portions of threads 2126are generally arcuate for engaging with outer threads 2140. A distalface 2126 ca of third thread 2126 c of driver 2120 is generallyperpendicular to needle 2106.

Driver 2120 of end effector 2100 also includes a finger 2127 extendingradially outward from the arm that does not include a thread at itsdistal portion. In the illustrated embodiment, first arm 2124 a includesfinger 2127. A distal face 2127 a of finger 2127 of driver 2120 isgenerally perpendicular to needle 2106 and generally parallel to distalface 2126 ca of third thread 2126 c. Distal face 2126 ca of third thread2126 c and distal face 2127 a of finger 2127 of driver 2120 are eachconfigured to mechanically engage a proximal surface of lip 2106 c ofneedle 2106.

With particular reference to FIG. 101, driver 2120 further includes tabs2128 disposed adjacent a distal end of each arm 2124. Tabs 2128 extendradially inward from the respective arm 2124, and are each configured toengage a recess 2106 d (FIG. 100) of needle 2106. Recess 2106 d ofneedle 2106 is disposed between proximal hub 2106 a and lip 2106 c ofneedle 2106.

Outer tube 2170 of end effector 2100 is configured for positioningradially outward of at least portions of needle 2106, drive assembly2110, driver 2120, and retraction spring 2130. Outer tube 2170 includesa first aperture 2172 disposed adjacent its distal end, and a secondaperture 2174 disposed proximally of first aperture 2172 (see FIGS. 101and 102). As shown in FIG. 102, first aperture 2172 is configured toengage (e.g., releasably engage) finger 2127 of driver 2120, and secondaperture 2174 is configured to engage (e.g., releasably engage) secondthread 2126 b of driver 2120.

Outer threads 2140 of outer tube 2170 extend radially inward from aninner wall 2171 of outer tube 2170, and are stationary with respect toouter tube 2170. Outer threads 2140 are configured to engage a portionof driver 2120 such that driver 2120 can move longitudinally androtationally within outer tube 2170 and with respect to outer tube 2170.

In use, in response to at least a partial actuation of the trigger ofsurgical device 100, drive rod 150 rotates, as discussed above. Withreference to FIGS. 102-103, initial rotation of the drive rod 150results in a corresponding rotation of drive assembly 2110 and driver2120 with respect to outer tube 2170 in the general direction of arrow“SBA” in FIG. 102. Due to the engagement between outer threads 2140 andfingers 2126 of driver 2120, rotation of driver 2120 in the generaldirection of arrow “SBA” results in a corresponding rotation and distaltranslation of driver 2120 with respect to outer tube 2170 in thegeneral direction of arrow “SBC” in FIG. 102. Distal translation ofdriver 2120 causes a corresponding distal translation of needle 2106.Further, distal translation of driver 2120 also causes a correspondingdistal translation of barbed suture 2102 due to the engagement betweenbarbed suture 2102 and distal face 2126 ca of third thread 2126 c anddistal face 2127 a of finger 2127.

Continued rotation of drive assembly 2110 in the general direction ofarrow “SBA” causes continued distal advancement of driver 2120 andneedle 2106 until distal tip 2106 b of needle 2106 extends a sufficientdistance distally beyond a distal end of outer tube 2170. Thus, toinsert needle 2106 and/or barbed suture 2102 into tissue, a distal endof end effector 2100 is positioned adjacent or in contact with tissue,and the trigger of surgical device 100 is at least partially actuated,thus distally advancing a portion of needle 2106 and/or barbed suture2102 into tissue.

With particular reference to FIG. 103, after a predetermined amount ofrotation of drive assembly 2110 and distal travel of needle 2106 (e.g.,corresponding to when distal tip 2106 b is sufficiently advanced withintissue), fingers 2126 of driver 2120 are advanced distally beyond outerthreads 2140. In this position, finger 2127 and second thread 2126 b ofdriver 2120 are axially aligned with first aperture 2172 and secondaperture 2174, respectively, of outer tube 2170. Here, outer tube 2170no longer resists the radially outward bias of arms 2124 of driver 2120,thus permitting arms 2124 to flex radially outward in the direction of“SBB” in FIG. 103 such that finger 2127 engages first aperture 2172, andthird thread 2126 c engages a distal notch 2173 of outer tube 2170.

Further, the radially outward movement of arms 2124 causes tabs 2128 ofdriver 2120 to disengage recess 2106 d of needle 2106. Thus, since theproximal force exerted by retraction spring 2130 is no longer opposed bythe engagement between driver 2120 and needle 2103, needle 2103 is ableto move proximally in the general direction of arrow “SBD” until needle2106 reaches the approximate position shown in FIG. 103. Since driver2120 is engaged with first aperture 2172 and distal notch 2173 of outertube 2170 and is no longer mechanically engaged with needle 2106, theproximal movement of needle 2106 causes at least a portion of needle2106 to move through cavity 2121 of driver 2120, while driver 2120remains adjacent a distal portion of outer tube 2170, as shown in FIG.103.

It is envisioned that end effector 2100 can be used more than once.After its initial use, as described above, a user can manually pullneedle 2106 distally (e.g., using a pliers-like tool) until recess 2106d of needle 2106 is axially aligned with tabs 2128 of driver 2120. Inthis position, while needle 2106 is being maintained in its longitudinalposition, a user can manually move arms 2124 of driver 2120 radiallyinwardly by exerting an appropriate force (e.g., through first aperture2172 and distal notch 2173) on third thread 2126 c and finger 2127 tocause tabs 2128 to engage recess 2106 d. Here, the proximal forceexerted by retraction spring 2130 causes both needle 2106 and driver2120 to move proximally to their initial positions such that endeffector 2100 can be used again to advance needle 2106. Additionally, ifa user wishes to use another barbed suture 2102, needle 2106 can bepulled farther proximally to allow an additional barbed suture 2102 toengage needle 2106 prior to driver 2120 re-engaging needle 2106.

While some embodiments of end effectors described herein have beendescribed as being re-usable, it is contemplated that any of the endeffectors described herein are configured for release, reloading and/orreuse.

In accordance with the present disclosure, it is contemplated that anelectromechanical control module may replace handle assembly 110 toactuate the surgical device 100. The electromechanical control modulemay include at least one microprocessor, at least one drive motorcontrollable by the at least one microprocessor, and a source of powerfor energizing the at least one microprocessor and the at least onedrive motor.

As can be appreciated, securement of any of the components of thepresently disclosed devices can be effectuated using known fasteningtechniques such welding, crimping, gluing, etc.

Additionally, the present disclosure includes methods of using thedisclosed end effectors, and methods of performing a surgical procedureutilizing the disclosed end effectors. An example of a disclosed methodincludes using a disclosed end effector to advance stay-sutures (e.g.,four stay-sutures) through an implant (e.g., mesh) to hold the implantin a desired position, removing the end effector from the handle portionof a surgical instrument, engaging a second end effector with the samehandle portion of the surgical instrument used to advance stay-suturesthrough the implant, and advancing tacks from the second end effectorthrough the implant.

The present disclosure also includes surgical systems. A disclosedsurgical system includes a surgical device, a first end effector and asecond end effector. The surgical device includes a handle assembly andan elongated portion extending distally from the handle assembly. Thefirst end effector is configured to releasably engage a distal portionof the elongated portion, and includes a drive assembly and a needleassembly. The drive assembly is configured to advance and retract theneedle assembly upon at least a partial actuation of the handle assemblyof the surgical device. The second end effector is configured toreleasably engage the distal portion of the elongated portion, includesa plurality of tacks therein, and is configured to distally advance theplurality of tacks upon at least a partial actuation of the handleassembly of the surgical device.

The present disclosure also includes surgical kits including a pluralityof first end effectors (e.g., pre-loaded with stay-sutures, barbedsutures, etc.), a plurality of second end effectors (e.g., pre-loadedwith a plurality of tacks), and a surgical device. The surgical deviceincludes a handle assembly and an elongated portion extending distallyfrom the handle assembly. Each of the first end effectors and second endeffectors is configured to releasably engage a distal portion of theelongated portion of the surgical device.

The various embodiments disclosed herein may also be configured to workwith robotic surgical systems and what is commonly referred to as“Telesurgery.” Such systems employ various robotic elements to assistthe surgeon and allow remote operation (or partial remote operation) ofsurgical instrumentation. Various robotic arms, gears, cams, pulleys,electric and mechanical motors, etc. may be employed for this purposeand may be designed with a robotic surgical system to assist the surgeonduring the course of an operation or treatment. Such robotic systems mayinclude remotely steerable systems, automatically flexible surgicalsystems, remotely flexible surgical systems, remotely articulatingsurgical systems, wireless surgical systems, modular or selectivelyconfigurable remotely operated surgical systems, etc.

The robotic surgical systems may be employed with one or more consolesthat are next to the operating theater or located in a remote location.In this instance, one team of surgeons or nurses may prepare the patientfor surgery and configure the robotic surgical system with one or moreof the surgical instruments disclosed herein while another surgeon (orgroup of surgeons) remotely controls the instrument(s) via the roboticsurgical system. As can be appreciated, a highly skilled surgeon mayperform multiple operations in multiple locations without leavinghis/her remote console which can be both economically advantageous and abenefit to the patient or a series of patients.

The robotic arms of the surgical system are typically coupled to a pairof master handles by a controller. The handles can be moved by thesurgeon to produce a corresponding movement of the working ends of anytype of surgical instrument (e.g., end effectors, graspers, knifes,scissors, etc.) which may complement the use of one or more of theembodiments described herein. The movement of the master handles may bescaled so that the working ends have a corresponding movement that isdifferent, smaller or larger, than the movement performed by theoperating hands of the surgeon. The scale factor or gearing ratio may beadjustable so that the operator can control the resolution of theworking ends of the surgical instrument(s).

The master handles may include various sensors to provide feedback tothe surgeon relating to various tissue parameters or conditions, e.g.,tissue resistance due to manipulation, cutting or otherwise treating,pressure by the instrument onto the tissue, tissue temperature, tissueimpedance, etc. As can be appreciated, such sensors provide the surgeonwith enhanced tactile feedback simulating actual operating conditions.The master handles may also include a variety of different actuators fordelicate tissue manipulation or treatment further enhancing thesurgeon's ability to mimic actual operating conditions.

It will be understood that various modifications may be made to theembodiments disclosed herein. Therefore, the above description shouldnot be construed as limiting, but merely as exemplifications of variousembodiments. Those skilled in the art will envision other modificationswithin the scope and spirit of the claims appended thereto.

What is claimed is:
 1. An end effector for use with a surgical device,the end effector comprising: a driver; a clip assembly disposed inmechanical cooperation with the driver, wherein rotation of the driverresults in longitudinal translation of the clip assembly; a needleassembly selectively engaged with the clip assembly; and a biasingelement disposed in mechanical cooperation with the needle assembly andconfigured to bias the needle assembly proximally.
 2. The end effectoraccording to claim 1, wherein the clip assembly engages the needleassembly when the needle assembly is in a first, proximal position, andwherein the clip assembly is free from engagement with the needleassembly when the needle assembly is in a distal position.
 3. The endeffector according to claim 1, wherein engagement between the clipassembly and the needle assembly resists the bias exerted on the needleassembly by the biasing element.
 4. The end effector according to claim1, further comprising an outer tube disposed radially outward of thedriver.
 5. The end effector according to claim 4, wherein the clipassembly includes at least one arm, and wherein the needle assembly isselectively engaged with the at least one arm of the clip assembly. 6.The end effector according to claim 5, wherein the at least one arm ofthe clip assembly is biased radially outward into contact with a portionof the outer tube.
 7. The end effector according to claim 6, wherein theouter tube includes at least one aperture defined with a distal portionthereof, and wherein a portion of the at least one arm of the clipassembly is configured to engage the at least one aperture after apredetermined amount of distal movement of the clip assembly withrespect to the outer tube.
 8. The end effector according to claim 7,wherein engagement between the at least one arm of the clip assembly andthe at least one aperture causes the clip assembly to be free fromengagement with the needle assembly, and results in proximal movement ofthe needle assembly with respect to the outer tube.
 9. The end effectoraccording to claim 4, further comprising a pin extending laterallythrough the outer tube, and wherein a proximal portion of the biasingelement is mechanically engaged with the pin.
 10. The end effectoraccording to claim 9, wherein the pin extends through a longitudinalslot of the clip assembly.
 11. The end effector according to claim 1,wherein the needle assembly includes a first needle extending distallyfrom a needle block, and a second needle extending distally from theneedle block, the first needle being parallel to the second needle. 12.The end effector according to claim 1, further comprising a suturedisposed in mechanical cooperation with a needle of the needle assembly.13. An end effector for use with a surgical device, the end effectorcomprising: a drive assembly; a driver disposed in mechanicalcooperation with the drive assembly, the driver including a threadedportion; a needle assembly disposed in mechanical cooperation with thedriver, wherein rotation of the drive assembly in a first directioncauses distal translation of the driver and the needle assembly withrespect to the drive assembly; and a biasing element disposed inmechanical cooperation with the needle assembly, the biasing elementconfigured to bias the needle assembly proximally.
 14. The end effectoraccording to claim 13, wherein the needle assembly is configured to moveproximally with respect to the driver.
 15. The end effector according toclaim 13, further comprising an outer tube disposed radially outward ofat least a portion of the drive assembly, wherein the threaded portionof the driver is configured to engage a threaded portion of the outertube.
 16. The end effector according to claim 13, wherein a proximalportion of the needle assembly is configured to directly engage a distalportion of the biasing element.
 17. The end effector according to claim13, wherein the needle assembly is configured to disengage from thedriver after the driver has distally travelled a predetermined amountwith respect to the drive assembly.
 18. The end effector according toclaim 13, wherein the driver includes a pair of arms biased radiallyoutwardly.
 19. The end effector according to claim 18, furthercomprising a tab extending radially inward from at least one arm of thepair of arms, the tab configured to releasably engage a recess of theneedle assembly.
 20. The end effector according to claim 18, furthercomprising an outer tube disposed radially outward of at least a portionof the drive assembly, the outer tube including at least one notchdisposed adjacent a distal end of the outer tube, wherein at least onearm of the pair of arms is configured to move from a first positionwhere the at least one arm is free from engagement with the at least onenotch, to a second position where the at least one arm is engaged withthe at least one notch.
 21. The end effector according to claim 18,wherein the pair of arms is biased from a first position where the pairof arms is engaged with the needle assembly to a second position wherethe pair of arms is free from engagement with the needle assembly. 22.The end effector according to claim 21, wherein engagement between thepair of arms and the needle assembly opposes a biasing force exerted bythe biasing element.
 23. The end effector according to claim 13, furthercomprising a suture disposed in mechanical cooperation with a needle ofthe needle assembly.